Dr. Braunstein on the Role of Daratumumab in Multiple Myeloma

Marc J. Braunstein, MD, PhD, assistant professor in the Department of Medicine at NYU Long Island School of Medicine, course co-director of the Hematology-Oncology System and co-director of the Autologous Stem Cell Transplant Program, NYU Winthrop Hospital of NYU Langone Health’s Perlmutter Cancer Center, discusses the role of daratumumab (Darzalex) in multiple myeloma.

Daratumumab is an FDA-approved monoclonal antibody that targets CD38, which is a target found on multiple myeloma plasma cells. This agent is being evaluated in new 3-drug and 4-drug combination regimens, Braunstein explains. For example, the phase 3 MAIA trial looked at the combination of daratumumab, lenalidomide (Revlimid), and dexamethasone (DRd) versus lenalidomide and dexamethasone (Rd) in patients with transplant-ineligible newly diagnosed multiple myeloma, Braunstein says.

Updated results from the study, which were presented during the 2020 ASH Annual Meeting & Exposition, demonstrated a 48-month progression-free survival rate of 60% with DRd versus 38% with Rd. Ultimately, the findings indicated that adding daratumumab to Rd continued to elicit deeper responses with higher rates of complete responses (CR​s) compared with Rd alone, Braunstein explains.

In addition, the phase 2 GRIFFIN trial evaluated daratumumab plus lenalidomide, bortezomib (Velcade), and dexamethasone (D-RVd) compared with RVd alone in patients with transplant-eligible multiple myeloma. Updated results, presented during the 2020 ASH Annual Meeting & Exposition, showed that, the stringent CR rate was 63.6% in the D-RVd arm versus 47.4% in the RVd arm. Furthermore, the total minimal residual disease (MRD)–negativity rate in the D-RVd arm was 62.5% compared with 27.2% in the RVd arm. After only examining the MRD-evaluable group of patients, the MRD-negativity rate was 78.3% in those who received D-RVd versus 39.4% in those who received RVd alone, Braunstein concludes.