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Daratumumab plus lenalidomide/dexamethasone in untreated multiple myeloma: analysis of key subgroups of the MAIA study

In the MAIA study (median follow-up, 56.2 months), daratumumab plus lenalidomide and dexamethasone (D-Rd) significantly improved progression-free survival (PFS) and overall survival versus lenalidomide and dexamethasone (Rd) alone in transplant-ineligible newly diagnosed multiple myeloma (NDMM). In...

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Main Authors: Moreau, Philippe (Author) , Facon, Thierry (Author) , Usmani, Saad Z. (Author) , Bahlis, Nizar (Author) , Raje, Noopur (Author) , Plesner, Torben (Author) , Orlowski, Robert Z. (Author) , Basu, Supratik (Author) , Nahi, Hareth (Author) , Hulin, Cyrille (Author) , Quach, Hang (Author) , Goldschmidt, Hartmut (Author) , O’Dwyer, Michael (Author) , Perrot, Aurore (Author) , Venner, Christopher P. (Author) , Weisel, Katja (Author) , Tiab, Mourad (Author) , Macro, Margaret (Author) , Frenzel, Laurent (Author) , Leleu, Xavier (Author) , Wang, George (Author) , Pei, Huiling (Author) , Krevvata, Maria (Author) , Carson, Robin (Author) , Borgsten, Fredrik (Author) , Kumar, Shaji (Author)
Format: Article (Journal)
Language:English
Published: 15 January 2025
In: Leukemia
Year: 2025, Volume: 39, Issue: 3, Pages: 710-719
ISSN:1476-5551
DOI:10.1038/s41375-024-02506-1
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41375-024-02506-1
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41375-024-02506-1
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Author Notes:Philippe Moreau, Thierry Facon, Saad Z. Usmani, Nizar Bahlis, Noopur Raje, Torben Plesner, Robert Z. Orlowski, Supratik Basu, Hareth Nahi, Cyrille Hulin, Hang Quach, Hartmut Goldschmidt, Michael O’Dwyer, Aurore Perrot, Christopher P. Venner, Katja Weisel, Mourad Tiab, Margaret Macro, Laurent Frenzel, Xavier Leleu, George Wang, Huiling Pei, Maria Krevvata, Robin Carson, Fredrik Borgsten & Shaji K. Kumar
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Summary:In the MAIA study (median follow-up, 56.2 months), daratumumab plus lenalidomide and dexamethasone (D-Rd) significantly improved progression-free survival (PFS) and overall survival versus lenalidomide and dexamethasone (Rd) alone in transplant-ineligible newly diagnosed multiple myeloma (NDMM). In this post hoc analysis of clinically important subgroups in MAIA (median follow-up, 64.5 months), transplant-ineligible patients with NDMM were randomized 1:1 to D-Rd or Rd. The primary endpoint was PFS; secondary endpoints included overall response rate (ORR) and measurable residual disease (MRD)-negativity rate (10-5). PFS favored D-Rd versus Rd in most subgroups, including patients aged ≥75 years (HR, 0.59; 95% CI, 0.44-0.79), frail patients (HR, 0.64; 95% CI, 0.48-0.85), patients with high-risk cytogenetics (HR, 0.59; 95% CI, 0.44-0.80), and patients with isolated gain(1q21) (HR, 0.36; 95% CI, 0.19-0.67). ORRs, MRD-negativity rates, and sustained (≥12 months) MRD-negativity rates were higher with D-Rd versus Rd across subgroups. In patients aged ≥75 years, rates of grade 3/4 and serious treatment-emergent adverse events (TEAEs) were similar for D-Rd and Rd, but discontinuation due to TEAEs was lower for D-Rd. Results support use of D-Rd for high-risk patients, supporting D-Rd as a standard of care for transplant-ineligible NDMM. This trial was registered at www.clinicaltrials.govas NCT02252172.
Item Description:Gesehen am 03.09.2025
Physical Description:Online Resource
ISSN:1476-5551
DOI:10.1038/s41375-024-02506-1

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