ASH 2021 | MUK Nine b update: Dara-CVRd induction plus dara-VRd consolidation for ultra-high risk NDMM and pPCL

Martin Kaiser, MD, FRCP, FRCPath, The Royal Marsden NHS Foundation Trust, London, UK, gives an update on the final results of the MUK Nine b trial (NCT03188172) in patients with ultra-high risk newly diagnosed multiple myeloma (NDMM) and primary plasma cell leukemia (pPCL). Patients enrolled in MUK Nine b received intensified induction therapy with dara-CVRd (daratumumab (dara) plus cyclophosphamide (C), bortezomib (V), lenalidomide (R) and dexamethasone (d)), followed by V-augmented autologous stem cell transplantation (ASCT) and dara-based consolidation therapy. Outcomes were compared to a ‘digital comparator arm’ that used molecularly matched patients from the near-concurrent NCRI Myeloma XI/XI+ trial (NCT01554852) who were treated with CRd or carfilzomib-CRd (KCRd) induction, ASCT, and R maintenance or observation. After a median follow-up of 27.1 months, the median progression-free survival (PFS) was not reached in MUK Nine b patients. The study showed that at 18 months, PFS was higher in patients from the MUK Nine b study compared to Myeloma XI patients. The difference between trial treatments increased over time, suggesting particular efficacy of dara-VRd in maintaining responses post ASCT. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.