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ASH 2025 | Daratumumab versus lenalidomide as maintenance therapy in newly diagnosed multiple myeloma

Urvi Shah, MD, Memorial Sloan Kettering Cancer Center, New York City, NY, discusses the final results from a randomized investigator-initiated trial (NCT04497961) that evaluated single-agent daratumumab versus lenalidomide as maintenance therapy in newly diagnosed multiple myeloma (MM). Dr Shah notes that this study provides evidence for the potential of daratumumab monotherapy as an effective maintenance strategy, particularly for patients who may not tolerate lenalidomide or prefer a monthly treatment option. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.

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Transcript

The standard of care for multiple myeloma patients has been lenalidomide maintenance after induction plus or minus transplant. More recently, as daratumumab has gained approvals for many different aspects of treatment as well as in the induction setting and based on the GRIFFIN trial, many patients are often getting doublet maintenance with daratumumab and lenalidomide...

The standard of care for multiple myeloma patients has been lenalidomide maintenance after induction plus or minus transplant. More recently, as daratumumab has gained approvals for many different aspects of treatment as well as in the induction setting and based on the GRIFFIN trial, many patients are often getting doublet maintenance with daratumumab and lenalidomide. There has been no other study looking at what is the effect of single-agent daratumumab versus single-agent lenalidomide in a head-to-head comparison trial. 

This study was evaluating quality of life as the primary endpoint and global health status scores. What we show is that there’s no difference in quality of life between daratumumab and lenalidomide. However, patients, and when we look at efficacy or response, while this is not powered to look at that, what we do see is that there are very comparable 12-month and 24-month progression-free survival rates and MRD negativity rates too, and serious adverse events as well. There isn’t a significant difference, although we may see a slightly higher infection risk with daratumumab, and we might see slightly higher quality of life issues around diarrhea with things like lenalidomide. So I think this is the first study that gives us some evidence around how maintenance with daratumumab could be an effective strategy in patients who may either not be tolerant of lenalidomide or who may want an option that they just have to come in monthly for treatment.

 

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