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Maintenance Therapy with Daratumumab ± Pomalidomide Following Salvage Autologous Stem Cell Transplantation in Relapsed Multiple Myeloma: Results from a Phase 2 Trial
Clinical Scorecard: Maintenance Therapy with Daratumumab ± Pomalidomide Following Salvage Autologous Stem Cell Transplantation in Relapsed Multiple Myeloma: Results from a Phase 2 Trial
At a Glance
Category
Detail
Condition
Relapsed/Refractory Multiple Myeloma
Key Mechanisms
Daratumumab (anti-CD38 monoclonal antibody) and Pomalidomide (immunomodulatory drug) as maintenance therapy post-ASCT.
Target Population
Adults (≥18 years) with relapsed/refractory multiple myeloma who have undergone salvage or delayed ASCT.
Care Setting
Single-center phase 2 trial at The University of Texas MD Anderson Cancer Center.
Key Highlights
Median follow-up from maintenance initiation was 48.5 months.
At 4 years post-ASCT, progression-free survival (PFS) was 62% and overall survival (OS) was 100%.
46% of patients achieved complete response (CR) or better at maintenance initiation; this increased to 85% at final assessment.
Neutropenia was the predominant grade ≥3 toxicity, occurring in 62% of patients.
75% of patients with evaluable MRD data achieved MRD negativity at 6 months.
Guideline-Based Recommendations
Diagnosis
Eligibility required a partial response or better to the latest treatment and ASCT performed 60–180 days before enrollment.
Management
Daratumumab is recommended as a post-ASCT maintenance option, often in combination with lenalidomide for high-risk patients.
Monitoring & Follow-up
Progression-free survival (PFS) and overall survival (OS) are key endpoints for monitoring treatment efficacy.
Risks
Adverse events, particularly neutropenia, should be monitored during treatment.
Patient & Prescribing Data
Adults with relapsed/refractory multiple myeloma who have undergone salvage or delayed ASCT.
Daratumumab alone or in combination with pomalidomide is used for maintenance therapy.
Clinical Best Practices
Consider maintenance therapy with daratumumab for patients with relapsed/refractory multiple myeloma post-ASCT.
Monitor for adverse events, especially hematologic toxicities like neutropenia.
by Oren Pasvolsky, Bruno Almeida Costa, Yosra M. Aljawai, Krina K. Patel, Qaiser Bashir, Dawen Sui, Samer A. Srour, Mark R. Tanner, Uday R. Popat, Neeraj Y. Saini, Chitra Hosing, Jeremy L. Ramdial, Hans C. Lee, Gregory P. Kaufman, Sheeba K. Thomas, Donna M. Weber, Melody Becnel, Guilin Tang, Robert Z. Orlowski, Richard E. Champlin, Yago Nieto, Elizabeth J. Shpall, Muzaffar H. Qazilbash
