Site Editors
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Wednesday, March 9, 2022
The UK OPTIMUM/MUKnine trial demonstrated a progression-free survival benefit at 18 months for intensified daratumumab combination therapy before and after autologous stem cell transplantation (ASCT) for ultra–high-risk newly diagnosed multiple myeloma. According to Martin F. Kaiser, MD, FRCP, FRCPath, of The Institute of Cancer Research, London, United Kingdom, and colleagues, these findings suggest the efficacy of such combination therapy in maintaining responses after ASCT. These results were presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 465).
The study screened 472 patients from 39 UK hospitals with suspected newly diagnosed multiple myeloma or primary plasma cell leukemia. Of these patients, 107 were found to have ultra–high-risk myeloma (at least two high-risk lesions or circulating plasmablasts greater than 20%). This final analysis reported the primary endpoint—progression-free survival at 18 months—for patients treated in the OPTIMUM trial with daratumumab plus CVRd (cyclophosphamide, bortezomib, lenalidomide, dexamethasone) induction, bortezomib-augmented ASCT, and daratumumab plus VRd consolidation compared with molecularly matched patients with ultra–high-risk myeloma from the Myeloma XI/XI+ trial (MyXI prior) treated with CRd or carfilzomib/CRd induction, ASCT, and lenalidomide maintenance or observation.
Of the featured 107 patients, progression-free survival was superior at 18 months for OPTIMUM patients, with an estimate of 81.7% versus 65.9% for the MyXI prior patients. Progression-free survival at 18 months was consistently shorter for those treated with both CRd (64.5%) and carfilzomib/CRd (68.3%) compared with the OPTIMUM patients. The difference between trial treatments increased over time: 6-month estimates were similar across all treatment arms with OPTIMUM (95.3%), MyXI carfilzomib/CRd (95.1%), and MyXI CRd (93.5%), whereas 12-month estimates were similar for OPTIMUM (87.5%) and MyXI carfilzomib/CRd (87.8%) but lower for CRd (81.7%).
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2021 ASH Annual Meeting & Exposition
JNCCN Spotlights
