Multiple Myeloma Coverage from Every Angle

Responses to Novel Drug Combination Among Patients With Multiple Myeloma

By: Cordi Craig
Posted: Monday, February 10, 2020

Luciano J. Costa, MD, PhD, of the University of Alabama at Birmingham, and colleagues suggested that the CD38-targeting antibody daratumumab in combination with carfilzomib, lenalidomide, and dexamethasone seems to be safe and effective among patients with newly diagnosed multiple myeloma. The novel quadruplet regimen is based on responses to measurable residual disease and may help reduce the treatment burden among patients. The study was presented at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 860) and published in the journal Blood.

“This approach can form the basis for clinical efforts to reduce the burden of continuous therapy in those with confirmed measurable residual disease–negative remissions,” the study team concluded.

The researchers enrolled 69 patients with newly diagnosed multiple myeloma. Of them, 38 patients have completed induction, and 22 patients have completed post-transplant assessment. Patients were treated with daratumumab, carfilzomib, lenalidomide, and dexamethasone.

By the end of the induction period, all patients responded to treatment. Most of the patients (92%) achieved at least a very good partial response after induction. Almost all of the patients (91%) who continued on to receive autologous transplantation achieved a complete response or stringent complete response to therapy. The rates of measurable residual disease–negative remission increased in response to induction, transplantation, and consolidation. Overall, 34%, 70%, and 80% of patients achieved measurable residual disease–negative remission after induction therapy, transplantation, and best response, respectively.

No patients discontinued treatment due to toxicities, although a single patient died of metapneumovirus pneumonia after transplant surgery. The most frequently reported grade 3 and 4 adverse events were neutropenia, infection, insomnia, hyperglycemia, and rash. Serious adverse events were reported in 15 patients and included pneumonia, fever, neutropenia, pulmonary embolism, and atypical hemolytic uremic syndrome.

Disclosure: For full disclosures of the study authors, visit

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