Adding Daratumumab to Carfilzomib-Based Therapy in Resistant Myeloma: CANDOR Trial
Posted: Wednesday, October 21, 2020
For patients with relapsed or refractory multiple myeloma, a regimen of carfilzomib, dexamethasone, and daratumumab (KdD) may result in prolonged, progression-free survival, compared with treatment with carfilzomib and dexamethasone, according to findings from the randomized phase III CANDOR trial, presented in The Lancet. Saad Z. Usmani, MD, of Atrium Health, Charlotte, North Carolina, and colleagues noted that the triple therapy benefits seemed to extend to those patients for whom lenalidomide was not an option.
“Overall, the immunomodulatory drug-free KdD regimen showed a favorable benefit-risk profile and represents an efficacious new standard of care for patients with relapsed or refractory multiple myeloma,” the authors concluded.
In this open-label study, the authors enrolled 466 patients with relapsed or refractory multiple myeloma from 102 sites across North America, Europe, Australia, and Asia. Patients were assigned either regimen of KdD or carfilzomib and dexamethasone.
After a median follow-up of 17 months, median progression-free survival was not reached for patients treated with KdD, compared with 15.8 months for those treated with carfilzomib and dexamethasone. The median treatment duration was longer with the triplet (70.1 weeks) than the doublet (40.3 weeks). “The treatment effect on progression-free survival was generally consistent across prespecified clinically important subgroups, including lenalidomide-exposed and lenalidomide-refractory subgroups,” the investigators commented.
The authors reported that grade 3 or higher adverse events occurred in 82% of patients treated with KdD, with 22% of adverse events leading to treatment discontinuation. For those treated with carfilzomib and dexamethasone, 74% of patients experienced grade 3 or higher adverse events, with 25% discontinuing treatment because of adverse events.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
