Comparing daratumumab with other treatment for multiple myeloma

This paper studied the effectiveness of daratumumab (Darzalex) in multiple myeloma patients who had received at least 1 previous treatment. This study concluded that daratumumab was more effective when used in combination with lenalidomide or bortezomib.

There is no standard treatment option for multiple myeloma that has relapsed or did not respond to treatment. Traditional therapy options include bortezomib (Velcade) and lenalidomide (Revlimid). Daratumumab is a new treatment. It is approved for patients who have received at least 1 previous treatment for multiple myeloma. Daratumumab can be combined with lenalidomide and dexamethasone (DRd) or with bortezomib and dexamethasone (DVd). It is not yet clear whether these treatments are more effective than other myeloma treatment options.

The results from 27 unique studies, including 10,549 patients, were included in this statistical analysis. These studies compared daratumumab to other common treatments for multiple myeloma, such as carfilzomib (Kyprolis) and elotuzumab (Empliciti). Patients had previously received at least one treatment.

Treatment with DRd was associated with a lower risk of worsening disease or death compared to other treatments. The risk was 40% lower compared to treatment with carfilzomib. The risk was 41% lower compared to treatment with elotuzumab. The treatment regimen DVd was also associated with a lower risk of worsening disease or death compared to all other treatments. 

There was a significantly better response to treatment with DRd compared to others. The only exception was treatment with carfilzomib and with cyclophosphamide (Cytoxan). There was also a significantly better response with DVd than all other treatments. The only exception was treatment with carfilzomib.  

The authors concluded that DRd and DVd were associated with a higher probability of good outcomes in patients who have received one or more previous treatments. 

This study was funded by Janssen Scientific Affairs, the manufacturers of daratumumab.