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Comparing Triplet Regimens in Newly Diagnosed Myeloma: Is There a Clear Winner?

By: Celeste L. Dixon
Posted: Wednesday, November 22, 2023

In transplantation-ineligible patients with newly diagnosed multiple myeloma, progression-free survival was longer in those who were treated with the monoclonal antibody daratumumab, lenalidomide, and dexamethasone vs those treated with the proteasome inhibitor bortezomib, lenalidomide, and dexamethasone, according to the results of TAURUS, a nine-center U.S. chart review study. Saad D. Usmani, MD, MBA, of Memorial Sloan Kettering Cancer Center, New York, and colleagues noted in Clinical Lymphoma, Myeloma & Leukemia that both regimens are preferred first-line treatments for this cohort. However, since no head-to-head clinical trials have compared their efficacy to date, these results may “help inform the selection of optimal first-line treatment and help improve [patients’] long-term outcomes.” In fact, they said, the findings “add to the growing body of evidence showing superiority” of the daratumumab-based vs the bortezomib-based regimen in this scenario.

TAURUS is the first real-world, head-to-head study comparing progression-free survival in transplantation-ineligible patients with newly diagnosed multiple myeloma, all aged 65 or older at diagnosis, who received first-line treatment with the daratumumab or bortezomib regimen in similar clinical settings. All patients in this group treated with the daratumumab regimen (n = 91; median follow-up, 18.3 months) and a randomly selected population receiving the bortezomib regimen (n = 87; median follow-up, 20.1 months) were included in the chart review.

Subsequently, 13 and 24 patients given the daratumumab and bortezomib regimens, respectively, experienced disease progression or death, suggesting a significantly lower risk of these events with daratumumab (adjusted hazard ratio = 0.35). Specifically, Dr. Usmani and co-investigators added, the rate of patients without disease progression or death at 6 months was 98.6% with the daratumumab regimen and 90.9% with the bortezomib regimen (P = .066); at 12 months, the rates were 93.9% and 74.2%, respectively (P = .006).

Disclosure: The study authors’ disclosure information can be found at

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