Shaji Kumar, MD, on Daratumumab Maintenance Following Transplant for Myeloma in CASSIOPEIA

At ASCO 2021, Shaji Kumar, MD, talked about the impact of adding daratumumab maintenance to therapy for patients with newly diagnosed multiple myeloma in the CASSIOPEIA trial.

CancerNetwork® sat down with Shaji Kuamr, MD, of the Mayo Clinic at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting to talk about which abstracts he thought offered the most promise. In response, he detailed findings regarding daratumumab (Darzalex) maintenance added to both treatment arms from the CASSIOPEIA trial (NCT02541383) of bortezomib, thalidomide, and dexamethasone (VTd) with or without daratumumab.


An important abstract that came out of ASCO was the results of the second randomization of the CASSIOPEIA study. This was a phase 3 trial that tried to ask [and] answer 2 different questions. One was [does] adding daratumumab to bortezomib, thalidomide, and dexamethasone, or the VTd regimen, as part of induction therapy improve the outcomes of patients going to an early transplant. We already knew the results of that randomization where the daratumumab/VTd was associated with better survival outcomes. The second question [was] does daratumumab maintenance given every 8 weeks better than no maintenance. The overall intent-to-treat analysis showed that the additional daratumumab did improve progression-free survival, but the improvements have [been] restricted to patients who did not see daratumumab as part of their induction therapy. If you already had seen daratumumab for 6 cycles as part of your induction and consolidation, then additional daratumumab as maintenance, at least not at that dose every 8 weeks, did not appear to improve the outcomes.


Moreau P, Sonneveld P; the CASSIOPEIA Investigators. Daratumumab (DARA) maintenance or observation (OBS) after treatment with bortezomib, thalidomide and dexamethasone (VTd) with or without DARA and autologous stem cell transplant (ASCT) in patients (pts) with newly diagnosed multiple myeloma (NDMM): CASSIOPEIA Part 2. J Clin Oncol. 2021;39(suppl 15):8004. doi:10.1200/JCO.2021.39.15_suppl.8004