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How to sequence BCMA-directed therapies in early relapsed/ refractory multiple myeloma
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Frontline quadruplet therapy for multiple myeloma: Update from SOHO 2024
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Quadruplet therapies combining anti-CD38 monoclonal antibodies, a proteasome inhibitor, an immunomodulatory agent, and dexamethasone in sequence with ASCT lead to deep and durable responses in NDMM.1 A review of outcomes in patients treated with upfront quadruplet therapies was presented at the Society of Hematologic Oncology (SOHO) 2024 Annual Meeting by Ajay Nooka.1
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| Key learnings: |
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The phase III PERSEUS (NCT03710603) trial demonstrated deep and durable responses with daratumumab + VRd compared with VRd in patients with transplant-eligible NDMM. |
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Real-world findings and long-term results from the CASSIOPEIA trials confirmed the benefit of daratumumab-based quadruplet therapies in NDMM. |
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Isatuximab + VRd demonstrated improved post-induction MRD negativity compared with VRd in the GMMG-HG7 (NCT03617731) trial. |
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The phase III IMROZ (NCT03319667) and BENEFIT (NCT04751877) trials demonstrated that quadruplet therapies can improve the depth of response and lead to high rates of MRD negativity. This translated into a 63% 5-year PFS benefit for isatuximab + VRd vs VRd in the IMROZ study. |
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Benefits of upfront quadruplet therapies in high-risk disease were demonstrated in the MASTER (NCT03224507) and GMMG-CONCEPT (NCT03104842) trials, and for transplant-ineligible elderly patients in the ALCYONE trial (NCT02195479). |
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These findings suggest upfront quadruplet therapies as the preferred SoC for transplant-eligible and transplant-ineligible patients. The depth of response and high PFS rates offer the potential for improved disease control, delaying relapse. |
ASCT, autologous stem cell transplantation; MRD, measurable residual disease; NDMM, newly diagnosed multiple myeloma; PFS, progression-free survival; SoC, standard of care; VRd, bortezomib + lenalidomide + dexamethasone.
- Nooka A. Session VI: Multiple Myeloma. Frontline therapy – Quads for everyone? Society of Hematologic Oncology (SOHO) 2024 Annual Meeting; Sep 4-7, 2024; Houston, US.
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