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EBMT 2026 | Anti-CD38 induction and consolidation approaches in transplant-eligible newly diagnosed myeloma
Jesús San Miguel, MD, PhD, University of Navarra, Pamplona, Spain, provides insights into the role of anti-CD38 antibody-containing induction and consolidation regimens in transplant-eligible, newly diagnosed multiple myeloma (MM). Prof. San Miguel outlines favorable outcomes observed in trials of combination therapies containing daratumumab or isatuximab and suggests that an anti-CD38 quadruplet approach represents the new standard of care for this patient population. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.
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Transcript
I think nowadays we have plenty of evidence showing that to use an anti-CD38 antibody as part of the induction and consolidation is associated with significantly higher response rate in terms of VGPR or CR, deeper response in terms of MRD, and prolonged progression-free survival. Probably the paradigm is the data presented in the PERSEUS trial that is comparing, in the setting of the transplant, for induction with VRD plus minus daratumumab, transplant consolidation, VRD plus minus daratumumab, two cycles, four cycles in induction, two cycles in consolidation, and then they move to maintenance in which in the daratumumab arm, they will continue with dara-len for two years...
I think nowadays we have plenty of evidence showing that to use an anti-CD38 antibody as part of the induction and consolidation is associated with significantly higher response rate in terms of VGPR or CR, deeper response in terms of MRD, and prolonged progression-free survival. Probably the paradigm is the data presented in the PERSEUS trial that is comparing, in the setting of the transplant, for induction with VRD plus minus daratumumab, transplant consolidation, VRD plus minus daratumumab, two cycles, four cycles in induction, two cycles in consolidation, and then they move to maintenance in which in the daratumumab arm, they will continue with dara-len for two years. And this study has shown for me something that is impressive. At four years, 84% of the patients remain progression-free. And the projected progression-free survival in median progression-free survival is 17 years.
Very similar data has been shown in a German trial using Isatuximab instead of Daratumumab. In other words, it’s VRD plus minus Isatuximab. The follow-up of this study is a bit shorter, and the hazard ratio is a bit higher, it’s 0.7 instead of 0.4, but we need longer follow-up, and I hope that the results are going to be very similar. But not only this, we have also, you see, another triplet, that is carfilzomib-lenalidomide-dexamethasone, plus minus isatuximab. And in this one, again, the quadruplet is associated with significantly higher MRD rate. Therefore, for me… and the same translates for the non-transplant patients. In the non-transplant candidates, VRD plus daratumumab or isatuximab is associated, the quadruplet, with significantly longer progression-free survival. For me, this is the new standard, is the use of a quadruplet.
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Disclosures
Advisory boards and consulting services on behalf of institution: Abbvie, Amgen, BMS, Celgene, GSK, HaemaLogiX, Johnson & Johnson, Karyopharm, MSD, Novartis, Pfizer, Takeda, Regeneron, Roche, Sanofi, SecuraBio, Gilead-Kite.
