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- Title
Daratumumab, lenalidomide, and dexamethasone in relapsed/refractory myeloma: a cytogenetic subgroup analysis of POLLUX.
- Authors
Kaufman, Jonathan L.; Dimopoulos, Meletios A.; White, Darrell; Benboubker, Lotfi; Cook, Gordon; Leiba, Merav; Morton, James; Joy Ho, P.; Kim, Kihyun; Takezako, Naoki; Moreau, Philippe; Sutherland, Heather J.; Magen, Hila; Iida, Shinsuke; Kim, Jin Seok; Miles Prince, H.; Cochrane, Tara; Oriol, Albert; Bahlis, Nizar J.; Chari, Ajai
- Abstract
High cytogenetic risk abnormalities confer poor outcomes in multiple myeloma patients. In POLLUX, daratumumab/lenalidomide/dexamethasone (D-Rd) demonstrated significant clinical benefit versus lenalidomide/dexamethasone (Rd) in relapsed/refractory multiple myeloma (RRMM) patients. We report an updated subgroup analysis of POLLUX based on cytogenetic risk. The cytogenetic risk was determined using fluorescence in situ hybridization/karyotyping; patients with high cytogenetic risk had t(4;14), t(14;16), or del17p abnormalities. Minimal residual disease (MRD; 10–5) was assessed via the clonoSEQ® assay V2.0. 569 patients were randomized (D-Rd, n = 286; Rd, n = 283); 35 (12%) patients per group had high cytogenetic risk. After a median follow-up of 44.3 months, D-Rd prolonged progression-free survival (PFS) versus Rd in standard cytogenetic risk (median: not estimable vs 18.6 months; hazard ratio [HR], 0.43; P < 0.0001) and high cytogenetic risk (median: 26.8 vs 8.3 months; HR, 0.34; P = 0.0035) patients. Responses with D-Rd were deep, including higher MRD negativity and sustained MRD-negativity rates versus Rd, regardless of cytogenetic risk. PFS on subsequent line of therapy was improved with D-Rd versus Rd in both cytogenetic risk subgroups. The safety profile of D-Rd by cytogenetic risk was consistent with the overall population. These findings demonstrate the improved efficacy of daratumumab plus standard of care versus standard of care in RRMM, regardless of cytogenetic risk.
- Subjects
DEXAMETHASONE; MULTIPLE myeloma; IN situ hybridization; CYTOGENETICS; PROGRESSION-free survival
- Publication
Blood Cancer Journal, 2020, Vol 10, Issue 11, p1
- ISSN
2044-5385
- Publication type
Article
- DOI
10.1038/s41408-020-00375-2