Dr. Susanibar-Adaniya on the Evolution of Combination Therapies in Multiple Myeloma

Sandra P. Susanibar-Adaniya, MD, assistant professor of medicine, University of Pennsylvania, Penn Medicine, discusses how advancements in triplet therapy have shifted the treatment paradigm for patients with newly diagnosed, transplant-ineligible multiple myeloma.

Current research indicates that most patients with newly diagnosed multiple myeloma will benefit from triplet therapy, Susanibar-Adaniya states. The previous standard of care for patients with transplant-ineligible multiple myeloma was a doublet of lenalidomide (Revlimid) plus dexamethasone. Data from the phase 3 MAIA study (NCT02252172) evaluating the addition of daratumumab (Darzlex) to this existing combination therapy showed that the resulting triplet therapy improved patient outcomes.

Existing data also support the combination of modified bortezomib (Velcade), lenalidomide, and dexamethasone (VRd) in this patient population, Susanibar-Adaniya continues. The triplet therapy was well-tolerated in patients and reduces the likelihood of treatment discontinuation due to toxicity.

Additionally, the potential benefits of quadruplet therapy in patients with transplant-eligible disease have become an important area of focus for continuing research, Susanibar-Adaniya notes. Preliminary studies evaluating the addition of daratumumab to the existing standard of VRd have shown progression-free survival benefit compared with VRd alone, but the overall survival benefit of this therapeutic regimen has not yet been determined.