Daratumumab, lenalidomide, and dexamethasone combination in relapsed/refractory myeloma patients: a real-life single-center experience

Daratumumab combined with dexamethasone and lenalidomide or bortezomib in relapsed/refractory multiple myeloma (RRMM) patients: Report from the multiple myeloma GIMEMA Lazio group

“…Antonioli et al. reported a real‐life single‐center experience on RRMM treated with DRd [ 32 ]. The authors reported a rate of ORR of 79% with CR observed in 13 pts with a 1‐year PFS and OS rate of 70% and 81%, respectively.…”

Lenalidomide-based triplet regimens in first relapsed multiple myeloma patients: real-world evidence from a propensity score matched analysis

“…(39,40) The few RWD on DaraRd found gaps in terms of response rate and PFS with respect to POLLUX trial, largely attributed to higher rate of baseline adverse prognostic factors like multiple comorbidities, advanced disease phases, lenalidomide refractoriness. (16,41) The population of our study had some homogeneous baseline characteristics (all patients were treated in first relapse, they were not primary refractory, and were mostly lenalidomide naïve), that could represent the clinical setting for better evaluating the real-life performances of DaraRd as well as KRd, and partly helps in limiting the well-known persistent bias of a retrospective analysis. (10) The adoption of the propensity score matched analysis, partly reduces the limits of our nonrandomized retrospective comparison by balancing for the several differences in baseline patients' characteristics.…”

“…Duration of active treatment in our study was comparable to RWD, but definitely lower than RCT, where the median duration of therapy was 34.3 months in POLLUX and 22 months in ASPIRE, with a progressive gain in response and PFS as long as patients stayed on continuous treatment. (6,7,16,18,19,36,41) In addition, some baseline characteristics may have influenced the general outcome in daily practice, partly explaining the gap between our RWD and RCT. Among relevant prognostic parameters, negative impact of high-risk cytogenetic has been improved, but not completely abrogated even by the most effective regimens employed, including DaraRd and KRd.…”

“…(12)(13)(14)(15) Although there are some real-life surveys focusing on the efficacy and tolerability of different Rdcombinations outside RCT, no real-world studies were specifically focused on the first relapse scenario. (16)(17)(18)(19) Therefore, to clarify this issue from real-world data (RWD), we conducted a retrospective analysis on a series of MM patients in first relapse, treated in 12 Italian centers with the aim to describe the pattern of use of different Rd-triplet regimens outside clinical trials and to show whether DaraRd and KRd, indicated as standard of care in recently updated guidelines, represent the most common used regimens in clinical practice. (10,11) Afterwards, in the attempt to limit as much as possible the well-known limitations and bias of any retrospective observation, we used the propensity score method (PSM), a well-established approach to perform an adjusted comparison between two distinct treatment options, to create two cohorts, balanced for predefined covariates, and assess in a real-world scenario the relative efficacy and tolerability of DaraRd over KRd.…”

“… 12-15 Although there are some real-life surveys focusing on the efficacy and tolerability of different Rd-combinations outside RCT, no real-world studies have been specifically focused on the first-relapse scenario. 16-19 Therefore, to clarify this issue from real-world data (RWD), we conducted a retrospective analysis on a series of MM patients in first relapse, treated in 12 Italian centers with the aim to describe the pattern of use of different Rd-triplet regimens outside clinical trials and to show whether DaraRd and KRd, indicated as standard of care in recently updated guidelines, represent the most commonly used regimens in clinical practice. 10 , 11 …”