Triplet Use at First Relapse Provides Better Survival Outcomes, Tolerance in MM

By Andrew Moreno - Last Updated: September 5, 2024

Researchers who conducted a study to evaluate daratumumab plus carfilzomib plus dexamethasone (DKD) in patients with early relapsed multiple myeloma (MM) have determined the triplet to be effective in this population.

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“DKD is effective in treating relapsed or refractory multiple myeloma, with better survival and good tolerance among patients [who] received DKD at first relapse,” the researchers concluded from their findings. Their study was presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

The retrospective database study included 29 patients with multiple myeloma who received DKD at relapse after at least one prior line of treatment. The total cohort had a median age of 60 years, and 17 patients were female. In addition, 26 patients were transplant eligible and 21 had undergone autologous stem cell transplantation prior to receiving DKD.

The cohort included 25 patients who had anemia, 23 with comorbidities, 10 who presented with infection, eight with extramedullary disease, four with plasma cells in peripheral blood, four with hyperdiploidy, and four who had Tp53 deletion. Furthermore, 10 patients had International Staging System stage 3 disease, 11 had stage 2 disease, and three had stage 1 disease.

The median follow-up for the total cohort was 14.7 months. Among the 13 patients who received DKD at first relapse, the objective response rate was 89%, progression-free survival was 55.17%, and overall survival at 12 months was 65.51%. The investigators wrote that these outcome measurements were all higher than in the 12 patients who received DKD as third-line therapy or later.

Grade 1 or 2 infection occurred in 22 patients when immunoglobulin G fell below 4 g/L and they received intravenous immunoglobulin, and five patients experienced life-threatening infections. One patient had a symptomatic decrease in left ventricular ejection fraction from a baseline of 65% to 43%.

The investigators underscored that therapy selection for relapsed multiple myeloma is complex and that “[t]riplet regimen containing at least two novel drugs to which the patient is sensitive should be considered.”

Reference

Ghonema R, Hasaneen M, Alshemmari S, et al. Retrospective analysis of a group of early relapsed multiple myeloma (MM) patients treated by daratumumab carfilzomib dexamethasone (DKD). Abstract #MM-285. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.

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