Efficacy of daratumumab in combination with lenalidomide plus dexamethasone (DRd) or bortezomib plus dexamethasone (DVd) in relapsed or refractory multiple myeloma (RRMM) based on cytogenetic risk status.

Authors

null

Katja C. Weisel

Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II, Tuebingen, Germany

Katja C. Weisel , Jesus San Miguel , Gordon Cook , Merav Leiba , Kenshi Suzuki , Shaji Kumar , Michele Cavo , Herve Avet-Loiseau , Hang Quach , Vania Hungria , Suzanne Lentzsch , Roman Hajek , Pieter Sonneveld , Kaida Wu , Xiang Qin , Christopher Chiu , David Soong , Ming Qi , Jordan Mark Schecter , Meletios A. Dimopoulos

Organizations

Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II, Tuebingen, Germany, Clinica Universidad de Navarra, Pamplona, Spain, St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom, Sheba Medical Center, Ramat Gan, Israel, Japanese Red Cross Medical Center, Tokyo, Japan, Division of Hematology, Mayo Clinic, Rochester, MN, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy, Unité de Génomique du Myélome, CHU Rangueil, Toulouse, France, University of Melbourne, St. Vincent's Hospital, Victoria, Australia, Irmandade da Santa Casa de Misericordia de São Paulo, São Paulo, Brazil, Division of Hematology/Oncology, Columbia University, New York, NY, University Hospital Ostrava and Faculty of Medicine and Faculty of Science, University of Ostrava, Ostrava, Czech Republic, Erasmus Medical Center, Rotterdam, Netherlands, Janssen Research and Development, LLC, Spring House, PA, Janssen Research and Development, LLC, Raritan, NJ, Janssen Research and Development, LLC, Raritan, NY, National and Kapodistrian University of Athens School of Medicine, Athens, Greece

Research Funding

Pharmaceutical/Biotech Company

Background: In 2 randomized phase 3 trials of RRMM patients (pts), DRd (POLLUX) or DVd (CASTOR) significantly improved PFS and deepened responses compared with Rd or Vd alone, respectively. The novel mechanism of action of daratumumab (D) may improve the poor prognosis associated with high-risk cytogenetic abnormalities in RRMM. Therefore, we examined the efficacy of DRd and DVd among RRMM pts with standard (std) or high cytogenetic risk status. Methods: Bone marrow aspirates were collected at screening and assessed centrally via next generation sequencing (NGS). Pts with high-risk cytogenetics included those who had ≥1 of the following abnormalities: t(4;14), t(14;16), or del17p; std-risk pts were defined as those confirmed negative for these abnormalities. Efficacy analyses included PFS and ORR. Results: Samples from 311/569 pts in POLLUX and 353/498 pts in CASTOR were assessed via NGS. In POLLUX, the median duration of follow-up was 17.3 months. Significantly longer median PFS and numerically higher ORR were observed with DRd vs Rd among high-risk patients, and significant improvements in these outcomes were observed in std-risk patients (Table). In CASTOR, the median duration of follow-up was 13.0 months. Significantly longer median PFS and higher ORR were observed with DVd vs Vd among both high- and std-risk pts (Table). Concordance rates for t(4;14), t(14;16), and del17p were high (88%-98%) between NGS and FISH. Updated data, including subgroup analyses, will be presented. Conclusions: In RRMM pts, the addition of D to standard-of-care regimens improved outcomes regardless of cytogenetic risk status. Targeting CD38 by combining D with Rd or Vd appears to improve the poor outcomes associated with high-risk cytogenetic status. See table. Clinical trial information: NCT02136134 and NCT02076009

NGSPOLLUX
CASTOR
High
Std
High
Std
DRd
(n=28)
Rd
(n=37)
DRd
(n=133)
Rd
(n=113)
DVd
(n=44)
Vd
(n=51)
DVd
(n=123)
Vd
(n=135)
Median PFS, moNR10.2NR17.111.27.2NR7.0
HR (95% CI)0.44 (0.19-1.03)0.30 (0.18-0.49)0.49 (0.27-0.89)0.29 (0.20-0.43)
P0.0475<0.00010.0167<0.0001
ORR, %8567958282628564
P0.140.00200.0390.0003
≥CR, %3365224309258
≥VGPR, %6331845164346427

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies—Plasma Cell Dyscrasia

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT02136134 and NCT02076009

Citation

J Clin Oncol 35, 2017 (suppl; abstr 8006)

DOI

10.1200/JCO.2017.35.15_suppl.8006

Abstract #

8006

Abstract Disclosures