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CASSIOPEIA Trial: Daratumumab Combination Therapy for Newly Diagnosed Multiple Myeloma

By: Joseph Fanelli
Posted: Monday, July 22, 2019

The addition of daratumumab to a regimen of bortezomib, thalidomide, and dexamethasone (VTd) resulted in “deepened responses” that led to improved outcomes with significant increases in minimal residual disease (MRD)-negative rates in patients with newly diagnosed multiple myeloma. These results from the phase III CASSIOPEIA trial were presented at the 2019 American Society of Clinical Oncology Annual Meeting (Abstract 8017) and published in the Journal of Clinical Oncology. Herve Avet-Loiseau, MD, PhD, of the IUCT-Oncopole at the Unite de Genomique du Myelome, Toulouse, France, and colleagues reported that MRD negativity correlated with a progression-free survival benefit, regardless of autologous stem cell transplantation status.

In part one of this clinical trial ( Identifier NCT02541383), the investigators assigned 1,085 patients who were diagnosed with transplant-eligible newly diagnosed multiple myeloma to four cycles of preautologous stem cell transplantation induction treatment followed by two cycles of postautologous stem cell transplantation consolidation treatment. Patients were then treated with daratumumab and VTd or VTd alone.

The authors discovered that postinduction and postconsolidation MRD negativity rates were significantly higher among patients treated with daratumumab plus VTd than with VTd alone. Postconsolidation MRD negativity rates were consistent across patient subgroups, including those with International Staging System stage III multiple myeloma and those with high-risk cytogenetics.

Patients who reached MRD negativity experienced a progression-free survival benefit, and daratumumab plus VTd also yielded a progression-free survival benefit (compared with VTd alone).

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

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