Comparing Dara-VTD, RVD in Transplant-Eligible Patients With Multiple Myeloma

A retrospective observational study presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas, compared the efficacy of daratumumab, bortezomib, thalidomide, and dexamethasone (Dara-VTD) with that of lenalidomide, bortezomib, and dexamethasone (RVD) as first-line treatment in patients with multiple myeloma who were eligible for autologous hematopoietic stem cell transplantation (HSCT).

New multiple myeloma treatment combinations have improved response rates and tolerability over the past two decades. Both Dara-VTD and RVD are recommended in clinical guidelines as first-line treatment in patients with multiple myeloma who are eligible for HSCT followed by maintenance with lenalidomide. However, no study had previously compared these strategies.

Physicians at Hospital Italiano de Buenos Aires conducted the study, comparing the two treatment strategies in patients treated between July 2016 and June 2021. Twenty patients received Dara-VTD, and 44 received RVD. International Myeloma Working Group criteria were used to evaluate the responses.

The study showed that “35% of the Dara-VTD group and 34% of the opposing group achieved stringent complete response on day +100 post-autologous stem cell transplant, with no statistically significant difference (P=0.9), but with a higher percentage (45%) of very good partial response.”

After a median follow-up of 24 months, neither group reached the median progression-free survival (PFS) or overall survival, but the 24-month PFS was 95% for Dara-VTD and 72% for RVD, with no statistically significant difference. The data also showed regarding measurable residual disease, “35% of the Dara-VTD group and 30% of the RVD group achieved a negative response on day +100 post-HSCT.”

Researchers concluded that Dara-VTD and RVD both are beneficial treatment regimens, “with a trend favoring the use of daratumumab in PFS, although without statistically significant differences.” However, they acknowledged that the lack of those differences could be due, in part, to the small sample size. They also noted that follow-up study “is expected to provide more data on the long-term effects of consolidation and maintenance.”

Reference

Huber M, Schutz N. Efficacy of first-line treatment with Dara-VTD and VRD in multiple myeloma patients eligible for autologous stem cell transplantation. Abstract #MM-142. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.