Saad Usmani, MD, Myeloma Specialist and Cellular Therapist at Memorial Sloan Kettering Cancer Center, discusses results from the CEPHEUS clinical trial in multiple myeloma (MM).
MM is a bone marrow-based plasma cell neoplasm characterized by a serum monoclonal protein and skeletal destruction. Common symptoms include osteolytic lesions, pathological fractures, bone pain, hypercalcemia, and anemia. The exact underlying cause of multiple myeloma is currently unknown.
The phase 3 CEPHEUS trial evaluated daratumumab plus bortezomib, lenalidomide, and dexamethasone (DVRd) versus VRd in patients with transplant-ineligible (TIE)/transplant-deferred (TD) newly diagnosed MM. A total of 395 patients were enrolled.
Of 298 standard-risk patients and 52 high-risk patients, minimal residual disease (MRD) negativity rates were significantly higher with DVRd in standard-risk (64% versus 38%) and revised standard-risk groups (68% versus 38%). However, MRD negativity rates were similar between treatment arms in high-risk (48% versus 56%) and revised high-risk (55% versus 45%) patient groups.
DVRd also significantly improved 1-year or greater sustained MRD negativity in standard-risk (51% versus 26%) and revised standard-risk (54% versus 24%). Rates remained comparable in high-risk (40% versus 37%) and revised high-risk (43% versus 30%).
Progression-free survival was improved with DVRd compared to VRd in standard-risk and revised standard-risk patients, while outcomes were similar across arms in high-risk and revised high-risk patients. DVRd was also favored in standard-risk and revised standard-risk groups in results from complete response, 2-year or greater sustained MRD negativity, and deep MRD negativity.
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