Prolonging Survival in MM: Daratumumab vs Pomalidomide Plus Dexamethasone

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Both daratumumab and pomalidomide plus low-dose dexamethasone are employed to treat patients with MM.
Both daratumumab and pomalidomide plus low-dose dexamethasone are employed to treat patients with MM.

Patients with multiple myeloma (MM) achieved greater prolongation in overall survival (OS) with daratumumab monotherapy compared with pomalidomide plus low-dose dexamethasone, according to a study published in The Oncologist

Daratumumab and pomalidomide plus low-dose dexamethasone are 2 regimens used to treat patients with heavily pretreated MM, but head-to-head comparison studies have yet to be conducted. For this study, researchers investigated which regimen resulted in greater improvements in overall survival.

Using a matching adjusted indirect comparison (MAIC), investigators analyzed the survival outcomes of patients with MM enrolled in 4 separate studies. The compiled results of 148 patients enrolled in the GEN501 and SIRIUS study treated with daratumumab 16 mg/kg were compared with results collected from the MM-003 and STRATUS studies that assessed pomalidomide plus low-dose dexamethasone.

The MAIC-adjusted hazard ratio (HR) for OS with daratumumab compared with that of pomalidomide plus dexamethasone in the MM-003 trial was 0.56 (95% CI, .038-0.83; P =.0041) and 0.51 (95% CI, 0.37-0.69; P <.0001) for STRATUS.

For the 66 patients in the GEN501/SIRIUS trial who were pomalidomide naïve, treatment benefit with daratumumab was even more pronounced in both MM-003 (HR, 0.33; 95% CI, 0.17-0.66; P =.0019) and STRATUS (HR, 0.41; 95% CI, 0.21-0.79; P =.0082).

The authors concluded that based on the results of the MAIC analysis, “daratumumab improves OS compared with pomalidomide + [low-dose dexamethasone] in patients with heavily pretreated multiple myeloma.” 

Reference

Van Sanden S, Ito T, Diels J, Vogel M, Belch A, Oriol A. Comparative efficacy of daratumumab monotherapy and pomalidomide plus low-dose dexamethasone in the treatment of multiple myeloma: a matching adjusted indirect comparison [Published online November 30, 2017]. Oncologist. doi: 10.1634/theoncologist.2017-0103

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