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ASH 2019: CANDOR Trial of Daratumumab Combination Therapy for Resistant Myeloma

By: Cordi Craig
Posted: Thursday, December 12, 2019

The primary analysis of the phase III CANDOR study in patients with relapsed or refractory multiple myeloma, presented at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition in Orlando, Florida (Abstract LBA-6), indicated carfilzomib, dexamethasone, and daratumumab treatment appears to be more beneficial than dexamethasone and carfilzomib alone. In fact, a 37% reduction in the risk of disease progression or death was reported with the triplet combination compared with the doublet combination.

“There is a need for novel, efficacious, and tolerable regimens that can treat patients with multiple myeloma who are exposed or refractory to lenalidomide or bortezomib,” Saad Z. Usmani, MD, MBBS, of Atrium Health, Charlotte, North Carolina, and colleagues stated.

The investigators randomly assigned 466 patients with relapsed or refractory multiple myeloma 2:1 to receive carfilzomib, dexamethasone, and daratumumab or carfilzomib and dexamethasone alone at 102 sites worldwide. Of the two groups, 42.3% and 90.3%, respectively, had received previous lenalidomide- and bortezomib-containing regimens, and 33% of patients were lenalidomide-refractory.

After a median follow-up of 17 months, the median progression-free survival was not reached for the group treated with carfilzomib, dexamethasone, and daratumumab, compared with 16 months for those treated with carfilzomib and dexamethasone. The addition of daratumumab resulted in deeper responses than did carfilzomib and dexamethasone alone, including superior overall response rates (84.3% vs. 74.7%). The rate of complete response or better was 28.5% vs. 10.4%, respectively. In addition, the investigators reported that the rate of undetectable minimal residual disease at 12 months was nearly 10 times higher with the triplet regimen (12.5% vs. 1.3%, respectively). 

The adverse events were reported to be generally manageable for both groups. Adverse events that were grade 3 or higher occurred in 82.1% and 73.9% of the patient pools, respectively.

Disclosure: For full disclosures of the study authors, visit

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