Site Editors

Shaji K. Kumar, MD

Prashant Kapoor, MD, FACP


ASH 2023: Quadruplet Regimen Followed by Doublet Maintenance Improves Outcomes in Multiple Myeloma

By: Joshua D. Madera, MD
Posted: Thursday, December 21, 2023

For patients with autologous stem cell transplantation (ASCT)-eligible, newly diagnosed multiple myeloma, subcutaneous use of the monoclonal antibody daratumumab in conjunction with bortezomib, lenalidomide, and dexamethasone (VRd) significantly improved the overall depth of response and rate of progression-free survival, based on the results of the PERSEUS study, presented at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract LBA-1). This combination treatment regimen did not result in additional treatment-related risks, according to Pieter Sonneveld, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, and colleagues.

“These data, together with results from the phase II GRIFFIN study..., support the combination of daratumumab plus VRd followed by daratumumab plus lenalidomide maintenance as a new standard of care for transplant-eligible newly diagnosed multiple myeloma,” stated the investigators.

A total of 709 patients with newly diagnosed multiple myeloma were recruited for the study. Patients were randomly assigned to receive treatment with subcutaneous daratumumab with VRd (n = 355) or VRd with lenalidomide maintenance therapy (n = 354). They were regularly monitored throughout treatment for the extent of their response and for evidence of disease progression.

The study authors reported improved progression-free survival in patients treated with the quadruplet vs the triplet (hazard ratio = 0.42). At the 48-month interval, the progression-free survival rates were 84.3% and 67.7% for patients treated with daratumumab plus VRd and VRd alone, respectively. In addition, those given the quadruplet regimen had higher rates of complete response to treatment (87.9%) and measurable residual disease negativity (75.2%) compared with patients given VRd alone (70.1% and 47.5%, respectively). Moreover, the most common treatment-emergent adverse events reported by patients included neutropenia (62.1% with daratumumab plus VRd vs 51.0% with VRd), thrombocytopenia (29.1% vs 17.3%), pneumonia (10.5% vs 6.1%), diarrhea (10.5% vs 7.8%), and febrile neutropenia (9.4% vs 10.1%).

Disclosure: For full disclosures of the study authors, visit

By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.