Sustained MRD Negativity With DVRd Signals Long-Term Survival in NDMM

At the 23rd Annual International Myeloma Society (IMS) Meeting & Exposition, Pieter Sonneveld, MD, PhD, a professor of hematology at Erasmus MC Cancer Institute in Rotterdam, the Netherlands, spoke with CancerNetwork® about how long-term findings from the phase 3 PERSEUS trial (NCT03710603) may shape the way clinicians counsel patients with transplant-eligible newly diagnosed multiple myeloma.

At a median follow-up of 81.3 months, subcutaneous daratumumab and hyaluronidase-fihj (Darzalex Faspro) plus bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (DVRd) induction and consolidation followed by daratumumab and lenalidomide maintenance continued to improve progression-free survival (PFS) vs VRd followed by lenalidomide maintenance (HR, 0.35; 95% CI, 0.26–0.46; P <.0001). The 6-year PFS rates were 81.1% vs 56.1%, respectively, and overall minimal residual disease (MRD)–negativity rates at the 10⁻⁵ threshold were 77.2% vs 50.3%. Although overall survival (OS) data remain immature, a trend towards improved OS emerged with DVRd (HR, 0.57; 95% CI, 0.40-0.81), even after MRD-guided discontinuation of daratumumab maintenance.

According to Sonneveld, patients who achieve and sustain MRD negativity with the quadruplet regimen can now be told they have a very good probability of long-term PFS and OS, with projections extending 10 to 17 years into the future.

Transcript:

Sonneveld: [Because] we see a plateau in the progression-free survival and a clear benefit for overall survival already, we can tell the patient that if they are MRD negative and remain MRD negative, they have a very good probability of long-term progression-free survival and also overall survival. We have previously demonstrated this with the projected long-term analysis, which is now being published in the Journal of Clinical Oncology. The long-term outcomes for this group of patients, those who are MRD negative with no signals of [multiple] myeloma, are projected to be very good, and they may be somewhere between 10 and 17 years in the future. This is one of the first times that we may observe these long-term outcomes.

Reference

Sonneveld P, Boccadoro M, Dimopoulos MA, et al. Long-term outcomes with daratumumab, bortezomib, lenalidomide, and dexamethasone (DVRd) versus VRd in transplant-eligible newly diagnosed multiple myeloma (TE-NDMM) in the phase 3 PERSEUS study. Presented at: 23rd International Myeloma Society Annual Meeting; September 23–26, 2026; Glasgow, Scotland. Abstract LBA-07.