Daratumumab for post-ASCT maintenance treatment of myeloma
Mené sur 886 patients atteints d'un myélome multiple et ayant reçu un traitement par bortézomib, thalidomide et dexaméthasone en combinaison ou non avec le daratumumab (âge : 18-65 ans ; durée médiane de suivi : 35,4 mois), cet essai international de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité du daratumumab en traitement d'entretien
Daratumumab, a potent CD38-directed monoclonal antibody, has veritably transformed the treatment landscape of multiple myeloma. CASSIOPEIA, a two-part, phase 3 trial, has brought daratumumab to the forefront of efforts aimed at improving outcome for transplant-eligible patients. Part 1 randomly assigned 1085 patients with newly diagnosed multiple myeloma to receive four pre-autologous stem-cell transplantation (ASCT) induction and two post-transplant consolidation cycles of bortezomib, thalidomide, and dexamethasone (VTd) alone, or in combination with daratumumab (D-VTd). D-VTd showed considerable improvement in depth of response and progression-free survival, leading to its regulatory approval. An improved overall survival with D-VTd became apparent with longer follow-up. 3 A more contemporary regimen, D-VRd, involving lenalidomide, is awaiting mature data.
The Lancet Oncology 2021