Daratumumab, bortezomib and dexamethasone at first relapse for patients with multiple myeloma: A real-world multicentre UK retrospective analysis.

Abstract

Daratumumab, bortezomib and dexamethasone (DVd) is approved for patients with relapsed multiple myeloma following the CASTOR phase 3 clinical trial. This retrospective multicentre analysis assesses the overall response rate (ORR) and progression-free survival (PFS) in routine clinical practice for patients at first relapse treated with DVd incorporating weekly bortezomib. Data were collected from 296 sequential patients treated across 15 UK centres. After a median follow-up of 21 months, the ORR was 82% (26% partial response, 56% very good partial response or better) and the median PFS was 16 months [95% confidence interval (CI) 12-20 months]. Results were similar regardless of prior lenalidomide exposure. The median time to next treatment was 20 months (95% CI 15-25 months) and the estimated overall survival at two years was 74%. Patients with high-risk features (by cytogenetics, International Staging System or extramedullary disease) and those treated within 18 months of initiation of progression-free treatment, or within 12 months of autologous stem cell transplant, had significantly inferior outcomes. The grade 2 and 3 peripheral neuropathy rate was 7%. DVd with weekly bortezomib was effective in a heterogenous real-world population at first relapse with a low rate of peripheral neuropathy. However, high-risk patients had inferior outcomes and should be considered for alternative treatments.

• Authors: Annabel McMillan, Supratik Basu, Kamaraj Karunanithi, Elizabeth Parkins, Edward Yan Ming Lau, Gordon Cook, Christopher Parrish, Firas Al-Kaisi, Guy Pratt, Salim Shafeek, Stephen Jenkins, Danish Memon, Ceri Bygrave, Xenofon Papanikolaou, Tara Maisel, Sandra Hassan, Shivir Moosai, Gurvin Chander, Pallav Rakesh, Bhuvan Kishore, Farheen Karim, Georgina Talbot, Farooq Wandroo, Kwee Yong, Rakesh Popat
• Journal: British journal of haematology (Br J Haematol) Vol. 201 Issue 4 Pg. 682-689 (05 2023) ISSN: 1365-2141 [Electronic] England
• PMID: 36822820 (Publication Type: Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2023 British Society for Haematology and John Wiley & Sons Ltd.

Chemical References

• Bortezomib
• daratumumab
• Dexamethasone

Topics

• Humans
• Multiple Myeloma
• Bortezomib (therapeutic use)
• Retrospective Studies
• Dexamethasone (adverse effects)
• Chronic Disease
• Recurrence
• United Kingdom (epidemiology)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)