Effect of daratumumab based four drug combinations on surrogate endpoints and high-risk features in newly diagnosed multiple myeloma: A systematic review.

Abstract

e20561 Background: Daratumumab (DARA) has shown benefit in combination with standard of care regimens in newly diagnosed multiple myeloma (NDMM). Methods: A literature search of PubMed, EmCare, clinicaltrials.gov, and Cochrane Library was performed on January 27, 2020 for DARA in NDMM. Six phase I/II and III trials met inclusion criteria out of 696 studies per PRISMA guidelines (n = 2146). Results: The median age was 58.5 – 71 years. DARA based quadruplet regimens were evaluated by Moreau et al (2019) and Mateos et al (2018) in stem cell transplant (SCT) eligible and ineligible patients respectively. These trials along with Voorhees et al (2019), Yimer et al (2019), Kapoor et al (2019) and Jakubowiak (2017) all reported improved surrogate endpoints (Table). African Americans were underrepresented and Hazard Ratio for disease progression in high-risk MM did not significantly improve by adding DARA. Conclusions: Combining DARA in the treatment of NDMM with/without SCT achieved improved surrogate endpoints without increased toxicity. With limited data, improvement is not noted in high-risk cytogenetics NDMM. Long term data is awaited. [Table: see text]