Loading
Adding daratumumab to the standard three-drug induction and to maintenance cut the risk of progression by more than half in transplant-eligible myeloma.
PERSEUS, trial NCT03710603 sponsored by the European Myeloma Network and Janssen and published in the New England Journal of Medicine in 2024, showed that adding daratumumab to bortezomib, lenalidomide and dexamethasone induction and to lenalidomide maintenance cut the risk of progression by more than half in transplant-eligible newly diagnosed myeloma. It randomised 709 patients, met its primary progression-free survival endpoint at 48 months with far higher and more sustained MRD negativity, and led to approval in July 2024, with daratumumab stopped after sustained MRD negativity in the experimental arm, embedding MRD-guided de-escalation. Whether transplant is still needed on top of a quadruplet is the open question.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
709 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 48 monthsprimary | Dara-VRd | 355 | 84.3% | 0.42 (0.3 to 0.59) | <0.0001 | link |
| VRd | 354 | 67.7% | ||||
| MRD negativity (10⁻⁵) | Dara-VRd | - | 75.2% | - | - | link |
| VRd | - | 47.5% |
Shares CD38 antibody added to PI-IMiD-dex (quadruplet induction), Daratumumab, Bortezomib, Lenalidomide.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Daratumumab, Bortezomib, Lenalidomide.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Daratumumab, Lenalidomide, Johnson & Johnson.
Shares CD38 antibody added to PI-IMiD-dex (quadruplet induction), MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶), Daratumumab, Lenalidomide.
Shares Daratumumab, Bortezomib, Lenalidomide, Johnson & Johnson.
Shares MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶), Daratumumab, Bortezomib, Lenalidomide.
Shares Daratumumab, Bortezomib, Lenalidomide, Johnson & Johnson.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Daratumumab, Bortezomib, Johnson & Johnson.