CENTAURUS Trial: Daratumumab Monotherapy for Smoldering Multiple Myeloma
Posted: Monday, May 11, 2020
Findings from the phase II CENTAURUS study presented in Leukemia suggest that daratumumab may be effective in treating patients with intermediate-risk and high-risk smoldering multiple myeloma. C. Ola Landgren, MD, PhD, of the Memorial Sloan Kettering Cancer Center, New York, and colleagues concluded that the monoclonal antibody could mitigate the progression of smoldering multiple myeloma to multiple myeloma.
“The potential risks of early intervention should be balanced with the comorbidities, diminished quality of life, and higher risk for death associated with multiple myeloma,” the authors observed. “Rapid advancements continue to be made in multiple myeloma therapy, and some of these new therapies may translate into development of earlier treatments for smoldering multiple myeloma.”
In this trial, 123 patients with intermediate-risk or high-risk smoldering multiple myeloma received 16 mg/kg of daratumumab on extended intense, extended intermediate, or short dosing schedules. Patients were monitored until disease progression and through the end of the current phase III study.
After a 15.8-month median follow-up, the complete response rates for intense, intermediate, and short dosing were 2.4%, 4.9%, and 0%, respectively. The median progression-free survival for all dosing groups was less than 24 months.
With a longer median follow-up of 25.9 months, the complete response rates for intense, intermediate, and short dosing schedules were 4.9%, 9.8%, and 0%, respectively. The 24-month progression-free survival rates were 89.9%, 82.0%, and 75.3% for intense, intermediate, and short dosing schedules, respectively. A pharmacokinetic analysis also indicated that intense dosing maintained target-saturating trough concentrations for most patients through weekly, biweekly, and 4-week dosing periods.
Disclosure: For a full list of the authors’ disclosures, visit nature.com.