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Evaluation of Sustained Minimal Residual Disease Negativity With Daratumumab-Combination Regimens in Relapsed and/or Refractory Multiple Myeloma:Analysis of POLLUX and CASTOR
- Source :
- Avet-Loiseau, H, San-Miguel, J, Casneuf, T, Iida, S, Lonial, S, Usmani, S Z, Spencer, A, Moreau, P, Plesner, T, Weisel, K, Ukropec, J, Chiu, C, Trivedi, S, Amin, H, Krevvata, M, Ramaswami, P, Qin, X, Qi, M, Sun, S, Qi, M, Kobos, R & Bahlis, N J 2021, ' Evaluation of Sustained Minimal Residual Disease Negativity With Daratumumab-Combination Regimens in Relapsed and/or Refractory Multiple Myeloma : Analysis of POLLUX and CASTOR ', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 39, no. 10, pp. 1139-1149 . https://doi.org/10.1200/JCO.20.01814
- Publication Year :
- 2021
-
Abstract
- PURPOSE In relapsed and/or refractory multiple myeloma, daratumumab reduced the risk of progression or death by > 60% in POLLUX (daratumumab/lenalidomide/dexamethasone [D-Rd]) and CASTOR (daratumumab/bortezomib/dexamethasone [D-Vd]). Minimal residual disease (MRD) is a sensitive measure of disease control. Sustained MRD negativity and outcomes were evaluated in these studies. METHODS MRD was assessed via next-generation sequencing (10−5) at suspected complete response (CR), 3 and 6 months following confirmed CR (POLLUX), 6 and 12 months following the first dose (CASTOR), and every 12 months post-CR in both studies. Sustained MRD negativity (≥ 6 or ≥ 12 months) was evaluated in the intention-to-treat (ITT) and ≥ CR populations. RESULTS The median follow-up was 54.8 months in POLLUX and 50.2 months in CASTOR. In the ITT population, MRD-negativity rates were 32.5% versus 6.7% for D-Rd versus lenalidomide and dexamethasone (Rd) and 15.1% versus 1.6% for D-Vd versus bortezomib and dexamethasone (Vd; both P < .0001). Higher MRD negativity rates were achieved in ≥ CR patients in POLLUX (D-Rd, 57.4%; Rd, 29.2%; P = .0001) and CASTOR (D-Vd, 52.8%; Vd, 17.4%; P = .0035). More patients in the ITT population achieved sustained MRD negativity ≥ 6 months with D-Rd versus Rd (20.3% v 2.1%; P < .0001) and D-Vd versus Vd (10.4% v 1.2%; P < .0001), and ≥ 12 months with D-Rd versus Rd (16.1% v 1.4%; P < .0001) and D-Vd versus Vd (6.8% v 0%). Similar results for sustained MRD negativity were observed among ≥ CR patients. More patients in the daratumumab-containing arms achieved MRD negativity and sustained MRD negativity, which were associated with prolonged progression-free survival. CONCLUSION Daratumumab-based combinations induce higher rates of sustained MRD negativity versus standard of care, which are associated with durable remissions and prolonged clinical outcomes.
- Subjects :
- Oncology
Cancer Research
medicine.medical_specialty
Neoplasm, Residual
Dexamethasone
Bortezomib
Internal medicine
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
Outcome Assessment, Health Care
medicine
Humans
Multicenter Studies as Topic
Prospective Studies
Lenalidomide
Randomized Controlled Trials as Topic
business.industry
Daratumumab
Antibodies, Monoclonal
Refractory Multiple Myeloma
Minimal Residual Disease Negativity
Progression-Free Survival
Clinical Trials, Phase III as Topic
Drug Resistance, Neoplasm
Neoplasm Recurrence, Local
business
Multiple Myeloma
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Avet-Loiseau, H, San-Miguel, J, Casneuf, T, Iida, S, Lonial, S, Usmani, S Z, Spencer, A, Moreau, P, Plesner, T, Weisel, K, Ukropec, J, Chiu, C, Trivedi, S, Amin, H, Krevvata, M, Ramaswami, P, Qin, X, Qi, M, Sun, S, Qi, M, Kobos, R & Bahlis, N J 2021, ' Evaluation of Sustained Minimal Residual Disease Negativity With Daratumumab-Combination Regimens in Relapsed and/or Refractory Multiple Myeloma : Analysis of POLLUX and CASTOR ', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 39, no. 10, pp. 1139-1149 . https://doi.org/10.1200/JCO.20.01814
- Accession number :
- edsair.doi.dedup.....f1f9158e42f9af71740e2dd3135ee07c