Salvage therapy with "Dara‐KDT‐P(A)CE" in heavily pretreated, high‐risk, proliferative, relapsed/refractory multiple myeloma.

The multi‐agent therapy "VDT‐PACE" represents an established regimen in relapsed/refractory multiple myeloma (RRMM). Here, we report on our experience with a "modified VDT‐PACE" incorporating new generation anti‐MM agents daratumumab and carfilzomib ("Dara‐KDT‐P(A)CE"). We retrospectively analyzed 38 patients with RRMM treated with "Dara‐KDT‐P(A)CE". The median age was 62 (range 45–82) years, and the patients were heavily pretreated with a median of 5 (range 2–12) prior lines of therapy. Twenty‐one (55%) patients suffered from penta‐refractory MM. High‐risk cytogenetics was present in 31 (81%) patients. The patients received a median of 2 (range 1–10) cycles of this therapy, and the overall response rate (ORR) was 70%. Patients with penta‐refractory MM and high‐risk cytogenetics showed similar ORR of 65% and 79%, respectively. The median progression‐free survival (PFS) and overall survival were 4.1 (95% CI 2.7–5.4) and 8.4 (95% CI 6.7–10.0) months, respectively. Patients with lactate dehydrogenase >250 IU/L showed significantly shorter PFS in comparison with others patients (p = 0.006). We used this regimen as bridging therapy prior to chimeric antigen receptor T‐cell infusion in four patients. In conclusion, "Dara‐KDT‐P(A)CE" is an effective salvage therapy for patients with heavily pretreated, multi‐refractory, high‐risk RRMM lacking alternative options. [ABSTRACT FROM AUTHOR]