CancerNetwork® sat down with Ola Landgren, MD, PhD, at the 2021 EHA Congress to talk about his presentation on first-line standard of care for multiple myeloma.
At the 2021 European Hematology Association (EHA) Congress, CancerNetwork® spoke with Ola Landgren, MD, PhD, about his presentation on treating patients with multiple myeloma, the importance of minimal residual disease (MRD), and emerging trends in the space.
At EHA 2021, I’m giving a talk entitled “New Momentum in First-Line Therapy.” I try to highlight, first of all, that MRD is the strongest predictor of clinical outcomes in patients with myeloma, and I refer to the 3 meta-analyses that have been published. Also, I shed light on some new studies; one of them is the GRIFFIN study [NCT02874742] that builds on the old VRd [bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone] paradigm that was developed initially by Paul G. Richardson, MD, and colleagues at the Dana-Farber Cancer Institute. The GRIFFIN study adds daratumumab [Darzalex], still with a transplant, showing that you can increase the MRD rate from 20% to 51%.1 [Patients on the trial were treated with] 6 cycles of therapy without and with daratumumab with a bone marrow transplant.
I also show the MANHATTAN trial that comes from [Memorial] Sloan Kettering and which we published in JAMA Oncology,2 delivering 71% MRD negativity with 8 cycles [of carfilzomib (Kyprolis), lenalidomide, and dexamethasone] without the transplant. That’s a pretty spectacular result.
Then I show data on sustained MRD negativity that seems to be a very strong predictor of long freedom from progression and also survival. And then I asked the question in this presentation, “where’s the field going?” My prediction is, as I already touched on here today, lack of detectable disease or sustained MRD negativity using more modern therapies, [such as] immunotherapy-based regiments, could continue to result in longer progression-free survival, but maybe also could deliver some cure in some patients. So those are questions I addressed in my talk.
1. Voorhees PM, Kaufman JL, Laubach J, et al. Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood. 2020;136(8):936-945. doi:10.1182/blood.2020005288
2. Landgren O, Hultcrantz M, Diamond B, et al. Safety and Effectiveness of Weekly Carfilzomib, Lenalidomide, Dexamethasone, and Daratumumab Combination Therapy for Patients With Newly Diagnosed Multiple Myeloma: The MANHATTAN Nonrandomized Clinical Trial. JAMA Oncol. published April 15, 2021. doi:10.1001/jamaoncol.2021.0611