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Adding the CD38 antibody daratumumab to standard lenalidomide-dexamethasone cut the risk of progression or death by about 44% in older myeloma patients, and later extended survival.
MAIA randomised 737 transplant-ineligible patients with newly diagnosed multiple myeloma (median age 73) to daratumumab plus lenalidomide and dexamethasone (D-Rd) or Rd alone, both continued until progression. The primary endpoint was PFS. At 30 months PFS was 70.6% versus 55.6% (hazard ratio 0.56); complete response or better was 47.6% versus 24.9% and MRD-negativity 24.2% versus 7.3%. Longer follow-up showed a significant overall survival benefit (hazard ratio about 0.68; five-year OS roughly 66% versus 53%). Neutropenia and pneumonia were more frequent with daratumumab.
MAIA made a daratumumab-based triplet the standard first treatment for older or frail myeloma patients, replacing Rd alone. It proved an anti-CD38 antibody could improve survival, not just delay progression, when used up front. Quadruplets built on this backbone are now being tested in the same population.
Shares CD38 antibody added to PI-IMiD-dex (quadruplet induction), CEPHEUS: daratumumab quadruplet for newly diagnosed myeloma patients not having a transplant, with MRD-negativity as the main endpoint, Newly diagnosed multiple myeloma, transplant-ineligible, Daratumumab.
Shares Thierry Facon, CD38 antibody added to PI-IMiD-dex (quadruplet induction), CEPHEUS: daratumumab quadruplet for newly diagnosed myeloma patients not having a transplant, with MRD-negativity as the main endpoint, Newly diagnosed multiple myeloma, transplant-ineligible.
Shares CD38 antibody added to PI-IMiD-dex (quadruplet induction), MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶), CD38, Daratumumab.
Shares CD38 antibody added to PI-IMiD-dex (quadruplet induction), MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶), Daratumumab, Lenalidomide.
Shares MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶), Daratumumab, Progression-free survival (PFS), Overall survival (OS).
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Daratumumab, Lenalidomide, Johnson & Johnson.
Shares Newly diagnosed multiple myeloma, transplant-ineligible, Daratumumab, Lenalidomide, Multiple myeloma.
Shares Daratumumab, Lenalidomide, Johnson & Johnson, Multiple myeloma.