Multiple Myeloma Coverage from Every Angle

Transplant-Ineligible Myeloma: Comparing Regimens With and Without Daratumumab

By: Joseph Fanelli
Posted: Tuesday, September 15, 2020

For patients with newly diagnosed multiple myeloma, treatment with the monoclonal antibody daratumumab in combination with lenalidomide and dexamethasone (D-Rd) may offer a reduced risk of disease progression and death, compared with the standard regimen of bortezomib, lenalidomide, and dexamethasone (VRd), according to findings from the PEGASUS trial presented in the American Journal of Hematology. Thierry Facon, MD, of Lille University Hospital, France, and colleagues compared the results of the two therapies using clinical trial results and real-world data.

“In the absence of head-to-head clinical trials comparing these regimens, these findings provide insight into the progression-free survival benefit of the newly approved D-Rd treatment combination regimen over other commonly used standard-of-care regimens for transplant-ineligible newly diagnosed multiple myeloma patients,” the authors concluded.

In this study, the investigators focused on data from the global MAIA phase III trial and the Flatiron Health electronic health record–derived de-identified database, which has data from patients treated primarily at community‐based oncology practices in the United States. The MAIA trial randomly assigned patients to receive D-Rd or lenalidomide and dexamethasone alone.

Based on the indirect treatment comparison, patients treated with D-Rd had a 32% reduction in the risk of disease progression or death, compared with those treated with VRd, and a 52% reduced risk of death or death when compared with patients who received the standard treatment. When the authors made a direct comparison within the MAIA trial, treatment with D-Rd also was associated with a significantly lower risk of disease progression or death, when compared with treatment with lenalidomide and dexamethasone alone.

Disclosure: For full disclosures of the study authors, visit

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