Study supports use of D-VRd in transplant-eligible newly diagnosed high- and standard-risk MM 

An analysis of the PERSEUS/EMN017 study found that the addition of daratumumab to VRd (bortezomib, lenalidomide, and dexamethasone) improved measurable residual disease (MRD) negativity and progression-free survival (PFS) in newly diagnosed multiple myeloma (MM). These improvements were observed across high- and standard-risk subgroups, per International Myeloma Society/International Myeloma Working Group consensus genomic staging.

Meletios Dimopoulos MD, of the National and Kapodistrian University of Athens in Greece, and colleagues presented the findings at the 2026 SOHO Annual Meeting.

The study included 709 transplant-eligible patients with newly diagnosed MM who were randomized 1:1 to receive D-VRd or VRd. Among 664 patients with bone marrow samples, 434 were eligible for next-generation sequencing. Patients at high risk included those with del17p/TP53 mutations; t(4;14), t(14;16), or t(14;20) with amp1q or del1p; amp1q and del1p; biallelic del1p; and high β2M with normal renal function. About a third of the group (n=152; 35%) were considered high risk, with 14% having del17p/TP53 mutations, 12% with IgH translocation with amp1q/del1p, and 9% with del1p with amp1q.

D-VRd increased MRD negativity rates compared with VRd in both high- (56% vs 26%; P=0.0001) and standard-risk (67% vs 39%; P<0.0001) patients. D-VRd resulted in sustained MRD negativity rates for 12 or more months in both the high- (37% vs 17%; P=0.0007) and standard-risk (53% vs 22%; P<0.0001) patients, and sustained MRD negativity was associated with superior PFS regardless of risk classification (P<0.0001).

D-VRd improved PFS in high- (hazard ratio [HR], 0.54; P=0.039) and standard-risk (HR, 0.38; P=0.001) patients.

The researchers indicated that the data support the use of D-VRd followed by daratumumab and lenalidomide maintenance therapy as standard of care for transplant-eligible newly diagnosed MM, regardless of cytogenetic risk.

This abstract was accepted and previously presented at the 2026 ASCO Annual Meeting.

Reference

Dimopoulos MA, Terragna C, Bolli N, et al. New IMS/IMWG consensus genomic staging risk criteria by next-generation sequencing: analysis of daratumumab benefit in both high- and standard-risk patients in the PERSEUS/EMN017 study. Abstract MM-326. Presented at the 2026 Society of Hematologic Oncology Annual Meeting; September 9-12, 2026; Houston.