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Daratumumab + VRd for transplant-eligible patients with NDMM: MRD analysis from the PERSEUS trial
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The phase III PERSEUS trial (NCT03710603) assessed the safety and efficacy of subcutaneous daratumumab plus bortezomib, lenalidomide, and dexamethasone (D-VRd) induction and consolidation followed by daratumumab plus lenalidomide (D-R) maintenance in transplant-eligible (TE) patients with newly diagnosed multiple myeloma (NDMM).1 Primary results from this trial were reported previously by the Multiple Myeloma Hub. Briefly, D-VRd followed by D-R maintenance improved progression-free survival, depth of response, and measurable residual disease (MRD) negativity vs VRd followed by R maintenance.1 Further results from this trial on the deepening of response and MRD negativity during maintenance were presented at the European Hematology Association (EHA) 2024 Hybrid Congress by Sonneveld.1 |
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MRD negativity (10−6) was higher in the D-VRd + D-R arm vs the VRd + R arm at the end of consolidation (34.4% vs 16.1%), up to 12 months (43.9% vs 20.9%), 24 months (57.7% vs 27.4%), and 36 months (63.9% vs 30.8%) and increased by ~30% during maintenance with D-R. |
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Among high-risk patients, D-VRd + D-R improved the MRD negativity at 10−6 (57.9% vs 30.8%) as well as sustained MRD negativity at 10−6 (30.3% vs 14.1%) vs VRd + R. |
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D-R maintenance was also associated with a higher proportion of MRD-positive patients converting to MRD negativity at 10−6 (56.7% vs 25.2%; p <0.0001) and sustained MRD negativity at 10−6 (31.3% vs 10.3%; p <0.0001) vs R. |
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Results of the MRD analysis from PERSEUS trial highlight the benefit of D-VRd followed by D-R maintenance in TE patients with NDMM, suggesting that this regimen could be the new standard of care for this patient population. |
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