EBMT 2026 | Modeling long-term PFS in transplant-eligible and ineligible NDMM treated with Dara-VRd

In this EBMT 2026 annual meeting in Madrid, I had the pleasure to present an oral communication about the projected outcome PFS over survival from two randomized trials. So for the sake of introduction, I would like to emphasize that this is about the PERSEUS trial. The PERSEUS trial has tested, and it’s already published in 2024, has tested the combination of daratumumab and VRD – bortezomib, lenalidomide, dexamethasone – with a transplant in maintenance, doublet maintenance, with daratumumab and lenalidomide versus a classical VRD, autotransplant, and lenalidomide maintenance. And the results are clearly in favor of the quadruplet, and this is why now it has become the standard of care using a quadruplet. There is also another quadruplet which is approved, namely isatuximab-VRD, roughly similar to daratumumab-VRD. 

And when you look into these results, actually, it is likely that the progression-free survival to be assessed, it will take us many, many years. So using some well-established statistical techniques, actually, we were able to demonstrate that the projected estimate of PFS and the best fit in these models was around 200 months for those patients receiving daratumumab VRD, autotransplant, dara-len maintenance in the PERSEUS trial. So you would appreciate that if you have to wait for such a long time, it’s a little bit complicated. And this is why this kind of studies with projected and estimated durations are crucial. 

And the same work has been done, actually, on the CEPHEUS trial. This is a non-transplant eligible population. These patients have received DARA VRD quadruplet. And again, the results of the estimates are suggesting something around 100 months of median PFS. 

So you can see, I think, now with the significant improvement of the efficacy of the available combinations, we have to rely more and more on new tools to get a better, a clearer picture about what’s going to happen in the next few years. And obviously, these figures are really interesting. And obviously, for the patient, these represent clearly good news, given, of course, the median age of myeloma at time of diagnosis. So my best guess that for the near future, given what we are able to achieve in the frontline, given the results we have in early relapse, probably multiple myeloma will need one or two lines of therapies. And speaking about cure is not a matter of hype anymore. I think this will become reality for many patients. And this is extremely rewarding to all of us.

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