Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis
Abstract
Abstract In previous analyses of MAIA, daratumumab plus lenalidomide/dexamethasone (D-Rd) significantly improved progression-free survival and overall survival (OS) versus lenalidomide/dexamethasone (Rd) in transplant-ineligible newly diagnosed multiple myeloma (NDMM). We report results on long-term OS and subsequent antimyeloma therapies from the MAIA final analysis. A protocol amendment (July 20, 2021) led to a long-term extension of MAIA, during which patients were followed for OS. A total of 737 patients were randomized to D-Rd ( n = 368) or Rd ( n = 369). At a median follow-up of 89.3 months (range, 0.0–102.2; interquartile range, 85.3–93.0), median OS was 90.3 months (95% confidence interval [CI], 80.8–not estimable [NE]) with D-Rd versus 64.1 months (56.0–70.8) with Rd (hazard ratio [HR], 0.67; 95% CI, 0.55–0.82); estimated 7-year OS rates were 53.1% (95% CI, 47.8–58.2) and 39.3% (34.1–44.5), respectively. Median time to subsequent antimyeloma treatment was not reached (95% CI, 84.1–NE) for D-Rd versus 42.4 months (33.5–50.6) for Rd (HR, 0.51; 95% CI, 0.41–0.63; P < 0.0001). Death due to adverse events occurred in 84 patients (D-Rd, n = 44/364 [12%]; Rd, n = 40/365 [11%]). With >7 years of follow-up, D-Rd demonstrated a new benchmark for median OS (7.5 years) in transplant-ineligible NDMM, further supporting frontline D-Rd use to maximize survival.
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Authors: Thierry Façon, Shaji Kumar, Robert Z. Orlowski, Nizar J. Bahlis, Philippe Moreau, Hartmut Goldschmidt, Supratik Basu, Cyrille Hulin, Sonja Zweegman, Katja Weisel, Aurore Perrot, Caroline Jacquet, Noopur Raje, Salomon Manier, Ajai Chari, Markus Hansson, Mohamad Mohty, Michel Delforge, Torben Plesner, Gordon Cook, Xavier Leleu, Hang Quach, Christopher P. Venner, Mourad Tiab, Margaret Macro, Laurent Frenzel, George Wang, Huiling Pei, Kasey Bolyard, Robin Carson, Fredrik Borgsten, Saad Z. Usmani
Institutions: University of Alberta, Icahn School of Medicine at Mount Sinai, Johnson & Johnson (United States), The University of Melbourne, Vrije Universiteit Amsterdam, University of Calgary, Heidelberg University, University Hospital Heidelberg, Sahlgrenska University Hospital, The University of Texas MD Anderson Cancer Center, Sorbonne Université, WinnMed, University of Leeds, Universität Hamburg, University Medical Center Hamburg-Eppendorf, Université de Caen Normandie, Centre Hospitalier Régional et Universitaire de Nancy, Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, Mayo Clinic, Université de Lille, Centre Hospitalier Universitaire de Lille, St Vincent's Hospital Melbourne, Vejle Sygehus, University of Southern Denmark, Nantes Université, National Center for Tumor Diseases, Hôpital Necker-Enfants Malades, Hôpital Cardiologique du Haut-Lévêque, The Royal Wolverhampton NHS Trust, Centre Hospitalier Universitaire de Caen Normandie, BC Cancer Agency, Leeds Trinity University, Centre Hospitalier Universitaire de Toulouse, Institute of Cancer Research, University of Wolverhampton, Institut universitaire du cancer de Toulouse Oncopole, Hôpital Claude Huriez, Centre de Recherche Saint-Antoine, Centre Hospitalier Universitaire de Poitiers, Roche (France), Centre Hospitalier Départemental Vendée