Meta-Analysis Investigates Daratumumab-Integrated Quadruple Therapy for Newly Diagnosed, Transplant-Eligible Patients With Multiple Myeloma

A meta-analysis suggests that incorporating daratumumab into standard triplet therapy for newly diagnosed, transplant-eligible patients with multiple myeloma (MM) is associated with higher response rates and reduced disease progression or mortality, although the researchers cautioned that the quadruple regimen also comes with a higher incidence of adverse events.

The study was presented during the poster session by Kleuber Arias Meireles Martins, MS, of the University Center of Belo Horizonte in Brazil at the 12^th Society of Hematologic Oncology Annual Meeting in Houston Texas.

The meta-analysis, which consisted of studies found in the Medline, Cochrane, Web of Science, and Embase databases, compared the efficacy and safety of quadruplet therapy (QT) with the addition of daratumumab versus triplet therapy alone. Included in the analysis, were 4 studies (3 randomized clinical trials and 1 retrospective cohort study) involving 2,081 patients (1,045 of whom received QT).

In the QT group, risk of disease progression or death was significantly lower (hazard ratio [HR], 0.44; 95% CI, 0.35-0.56; P<0.01; I²=0%) and progression-free survival was significantly improved (risk ratio [RR], 1.11; 95% CI, 1.05-1.18; P<0.001; I²=0%). Patients treated with QT also demonstrated significantly higher overall response rates (RR, 1.02; 95% CI, 1.00-1.04; P=0.03; I²=0%) and significantly better results in minimal residual disease negativity rate assessment (RR, 1.57; 95% CI, 1.39-1.78; P<0.01; I²=40%).

In terms of safety, however, the QT group exhibited a significantly higher incidence of both hematological and nonhematological adverse effects.

“The findings suggest that incorporating daratumumab into standard triple therapy for treating patients with newly diagnosed multiple myeloma who are transplant eligible is associated with higher response rates and reduced disease progression or mortality,” the researchers concluded. “However, it is important to note that this regimen also comes with a higher incidence of adverse events.”

Reference

Martins KAM, Cardosa LJ, Ribeiro FM, et al. Abstract MM-571. Presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology. September 4-7, 2024; Houston, Texas.