New standard of care emerges for multiple myeloma (59% no detection rate)

Medical Xpress / U of Miami Schl of Med / Annual Meeting of the Am Society of Clinical Oncology ^ | May 30, 2025 | Charlotte Schubert / C. Ola Landgren, M.D., Ph.D. et al

[ConservativeMind]

A new four-drug combination is highly effective and safe in patients with newly diagnosed multiple myeloma, according to dats.

The randomized, multi-center trial tests the effects of adding the targeted drug daratumumab to the standard three-part therapy regimen, called KRd (carfilzomib, lenalidomide and dexamethasone).

The new clinical trial has its roots in the MANHATTAN trial. In that, newly diagnosed multiple myeloma patients were also treated with daratumumab added to KRd, a combination called DKRd.

The results of the MANHATTAN trial were "spectacular," said Landgren. Sensitive methods to assess for minimal residual disease (MRD) showed that 71% of patients had no detectable disease after completing their treatment. That trial, however, was a single-arm study—all 41 patients received DKRd.

The ADVANCE trial goes further by directly comparing KRd to DKRd in a large, multi-center, randomized (1:1) clinical trial in the U.S.

Half of the 306 patients in the ADVANCE trial were randomly assigned to treatment with KRd and half to DKRd.

The new results show that 59% of DKRd-treated patients were MRD-negative after eight cycles of treatment compared with 36% of KRd-treated patients.

The longer-term durability of the response is an open question. However, the data so far are encouraging: at 32.7 months of follow-up, 86% of patients on DKRd showed progression-free survival, compared to 79% of patients on KRd.

"…it is an extremely safe and very effective therapy," said Landgren.

The new four-drug combination leverages a range of therapeutic targets and modalities. Carfilzomib inhibits the protein-degrading machinery in cells, and lenalidomide stimulates immune activity against tumors, among other actions. Dexamethasone has effects on immunity and inflammation.

These three drugs may shrink tumors enough to enable daratumumab to finish the job, said Landgren. Daratumumab targets the CD38 protein on multiple myeloma cells and induces tumor cell death.

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TOPICS: Health/Medicine
KEYWORDS: therapy; tumor

[ConservativeMind]

59% of patients had no disease that could be found, as of the eighth treatment. At 32.7 months, 86% had progression-free survival.

[ConservativeMind]

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[shanover]

I suspect I got Myeloma in the Army. Bad water and solvents most likely the culprits. I am DRVd regimen and it works well. This four drug swaps Velcade with Kyprolis (Carfilzomib).

[Big Red Badger]

Fascinating
.
I’m finishing my 7th month of “DARA”

[RckyRaCoCo]

bfl

[Sicon]

A new four-drug combination is highly effective and safe

”effective and safe”

Hmmm, that sounds familiar.

[Rural_Michigan]

MM took my mother. It took 5 years but it got her eventually.

[KC Burke]

I had a stage 3 stomach cancer tumor and a new (in 2019) four chemo FLOT left me cancer free after stomach removal. Six years from diagnosis next month.

Oncology is like defending Stalingrad

[Big Red Badger]

A year ago many things struck.The
Good Lord is Working Mightily!
.

[Big Red Badger]

How Long ago, if I may Ask ?
Afriends’ dad got 15 years they
Lived in Michigan.