P04: Daratumumab Plus Bortezomib and Dexamethasone Versus Bortezomib and Dexamethasone Alone in Patients With Previously Treated Multiple Myeloma: Overall Survival Results From the Phase 3 Castor Trial

Sonneveld, P.; Chanan-Khan, A; Weisel, Katja; Nooka, Ajay K.; Beksaç, Meral; Špıčka, Ivan; Hungria, Vânia; Munder, Markus; Mateos, M.V.; Mark, TM; Levin, M-D.; Ahmadi, T.; Qin, Xiang; Mayo, Wendy Garvin; Gai, X; Carey, Jodi; Carson, Robin; Spencer, Andrew

doi:10.1097/01.hs9.0000829588.31575.a9

Cited by 3 publications

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“…7,8 In the CASTOR study, daratumumab, bortezomib and dexamethasone (DVd) demonstrated a significant improvement in overall survival over bortezomib and dexamethasone (Vd) for patients after 1-3 prior lines [hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.59-0.92; p = 0.0075]. [9][10][11] The most significant improvement was for those treated after one prior line (1PL) of therapy for whom PFS was 27 versus 7.9 months [HR, 0.22; 95% CI, 0.15-0.32; p < 0.0001, overall response rate (ORR) 92% vs. 74%; p < 0.0007] and OS not reached versus 47 months (HR 0.56; 95% CI, 0.39-0.8; p = 0.0013). [11][12][13] However, this trial incorporated biweekly bortezomib which limits tolerability due to treatmentemergent peripheral neuropathy 14 and the weekly schedule is commonly utilised in routine practice to mitigate this.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] The most significant improvement was for those treated after one prior line (1PL) of therapy for whom PFS was 27 versus 7.9 months [HR, 0.22; 95% CI, 0.15-0.32; p < 0.0001, overall response rate (ORR) 92% vs. 74%; p < 0.0007] and OS not reached versus 47 months (HR 0.56; 95% CI, 0.39-0.8; p = 0.0013). [11][12][13] However, this trial incorporated biweekly bortezomib which limits tolerability due to treatmentemergent peripheral neuropathy 14 and the weekly schedule is commonly utilised in routine practice to mitigate this. 15 Other anti-CD38 Mab combinations including carfilzomib have been evaluated at first relapse and may also be considered.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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Clinical evidence for immune-based strategies in early-line multiple myeloma: current challenges in decision-making for subsequent therapy

et al. 2023

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Almost all patients with multiple myeloma (MM) will eventually develop disease that has relapsed with or become refractory to available treatments and will require additional therapy. However, data are still lacking on how best to sequence regimens in the relapsed/refractory (RR) setting after the failure of early-line lenalidomide, bortezomib, and/or daratumumab, the most commonly used agents in clinical practice today. With the treatment landscape rapidly changing in response to emerging clinical trial data and approvals of several new drugs and additional combinations, it is critically important to focus on patients with RRMM. Variability in patient baseline characteristics, such as the number of prior lines of treatment, refractoriness to prior treatments, prior stem cell transplant, and timing and dosing of prior lenalidomide, makes it difficult to select the best options for patients with RRMM for whom first-line treatments have failed. The aim of this review is to provide both an overview of current therapies and future directions within the RRMM treatment landscape, and a framework for clinicians to choose the most promising next treatment option.

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A glimpse into relapsed refractory multiple myeloma treatment in real-world practice in Spain: the GeminiS study

Ríos-Tamayo,

Soler,

García-Sánchez

et al. 2023

Hematology

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P04: Daratumumab Plus Bortezomib and Dexamethasone Versus Bortezomib and Dexamethasone Alone in Patients With Previously Treated Multiple Myeloma: Overall Survival Results From the Phase 3 Castor Trial

Cited by 3 publications

References 0 publications

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

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

Clinical evidence for immune-based strategies in early-line multiple myeloma: current challenges in decision-making for subsequent therapy

A glimpse into relapsed refractory multiple myeloma treatment in real-world practice in Spain: the GeminiS study

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