In a nutshell
The study compared the use of lenalidomide (Revlimid) and dexamethasone (Decadron) alone and with daratumumab (Darzalex) in patients with relapsed or unresponsive multiple myeloma (MM). The study showed that patients receiving all three drugs had better treatment response and survival.
Some background
MM is a type of cancer that affects blood cells known as plasma cells. It often goes unnoticed for many years. Immunotherapy has greatly improved the outcomes of patients with MM. Daratumumab (D) is an immunotherapy that has been used in pre-treated unresponsive MM. It has also been used in combination with lenalidomide (R) and dexamethasone (d) in newly diagnosed multiple myeloma with a good response.
In a short-term analysis, the combination D-Rd has shown to improve survival without cancer worsening in patients with previously treated, unresponsive MM. However, the long-term outcomes of this combination in these patients remain under investigation.
Methods & findings
569 patients with previously treated, relapsed or unresponsive MM were included in this study. They were randomly assigned into two groups. Group 1 received D-Rd treatment. Group 2 only received Rd treatment. The patients were followed up for an average of 44.3 months.
Group 1 patients had a significantly longer average survival without cancer worsening (44.5 months) compared to group 2 (17.5 months). There was a 56% higher chance of a longer survival without disease worsening in group 1.
The overall response rate (ORR) in group 1 was 92.9%. In group 2, the ORR was 76.4%. 56.6% of patients in group 1 achieved a complete response (CR; no signs of cancer). This was compared to 23.2% in group 2.
No new safety concerns were reported. The most common side effect was low white blood cell levels (63.3% in group 1 vs 48% in group 2).
The bottom line
This study determined the daratumumab combined with lenalidomide and dexamethasone improves the outcomes of patients with relapsed or unresponsive MM.
The fine print
This study was funded by Janssen, the manufacturer of daratumumab.
Published By :
Leukemia
Date :
Jan 30, 2020
