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

Abstract

Summary 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.

Response rates to second‐line treatment with daratumumab bortezomib dexamethasone (DVD) in relapsed/refractory light chain amyloidosis (AL) after initial Bortezomib‐based regime

“…In patients with relapsed myeloma who have received at least one prior line of therapy, it showed an improved overall response rate (ORR), progression‐free survival (PFS) and overall survival (OS) when compared to bortezomib and dexamethasone alone. Real‐world evidence for DVD in myeloma supports these findings highlighting a 56% very good partial haematological response (VGPR)/CR response rate and median PFS of 16 months 9 …”

“…Real-world evidence for DVD in myeloma supports these findings highlighting a 56% very good partial haematological response (VGPR)/CR response rate and median PFS of 16 months. 9 The role of daratumumab, either as monotherapy or in combination in AL amyloidosis is well recognised in both the upfront and relapsed settings. 10,11 The use of DVD specifically in AL amyloidosis demonstrated a VGPR/CR rate of 55% in the relapsed setting although not specifically as second-line therapy in those treated with frontline bortezomib-based regime.…”