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CancerNetwork® sat down with Luciano Costa, MD, PhD, at the 2021 International Myeloma Workshop to discuss the benefit of treatment with daratumumab, carfilzomib, lenalidomide, and dexamethasone and the population of patients with newly diagnosed myeloma who will best benefit from treatment.
At the 2021 International Myeloma Workshop, CancerNetwork® spoke with Luciano Costa, MD, PhD, of O’Neal Comprehensive Cancer Center, to discuss lessons learned from the phase 2 MASTER trial (NCT03224507), examining daratumumab (Darzalex), carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone in patients with newly diagnosed multiple myeloma. He highlights how the quadruplet regimen is particularly safe in young, fit patients and how a deepened response can be achieved in minimal residual disease (MRD)–positive patients through consolidation therapy.
The thing to be learned that [is] immediately useful is that this is a safe combination that can be used, particularly in those patients who are young or fit, and you want to be, ambitious, and want to have a hope of deep, sustained MRD-negative response. This is a very helpful regimen. The other thing that we learned is that some of the patients who are still MRD positive after transplant get a further deepening of response with consolidation therapy using the same drugs or using induction. That is important because the role of consolidation therapy in myeloma has been very controversial, since some trials are positive [and] some trials are negative. I think a big part of the problem is that the trials [are] trying to find universal answers to the totality of the patients. When you look at individual level now that [we] have tools that allow us to precisely measure disease burden at a much lower level, you can clearly see the patients who are benefiting the most. For those patients who have high-risk disease [and] remain MRD positive post-transplant, they will not hesitate to offer consolidation therapy, even with quadruplets. I think those are things that can really be extrapolated right away from this study.
Costa LJ, Chhabra S, Medvedova E, et al. Daratumumab, carfilzomib, lenalidomide and dexamethasone (Dara-KRd), autologous transplantation and MRD response-adapted treatment duration and cessation in newly diagnosed multiple myeloma (NDMM). Paper presented at: 18th International Myeloma Workshop; September 8-11, 2021; Vienna, Austria. Accessed September 11, 2021.