Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: Frailty subgroup analysis of MAIA
Authors
Facon, ThierryCook, Gordon
Usmani, Saad Z.
Hulin, Cyrille
Kumar, Shaji
Plesner, Torben
Touzeau, Cyrille
Bahlis, Nizar
Basu, Supratik
Nahi, Hareth
Goldschmidt, Hartmut
Quach, Hang
Mohty, Mohamad
Venner, Christopher P.
Weisel, Katja
Raje, Noopur
Hebraud, Benjamin
Belhadj-Merzoug, Karim
Benboubker, Lotfi
Decaux, Olivier
Manier, Salomon
Caillot, Denis
Ukropec, Jon
Pei, Huiling
Rampelbergh, Rian Van
Uhlar, Clarissa M.
Kobos, Rachel
Zweegman, Sonja
Issue Date
2022-01-02
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In the phase 3 MAIA study of patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab/lenalidomide/dexamethasone (D-Rd) improved progression-free survival (PFS) versus lenalidomide/dexamethasone (Rd). We present a subgroup analysis of MAIA by frailty status. Frailty assessment was performed retrospectively using age, Charlson comorbidity index, and baseline Eastern Cooperative Oncology Group performance status score. Patients were classified as fit, intermediate, non-frail (fit+intermediate), or frail. Of the randomized patients (D-Rd, n=368; Rd, n=369), 396 patients were non-frail (D-Rd, 196 [53.3%]; Rd, 200 [54.2%]) and 341 patients were frail (172 [46.7%]; 169 [45.8%]). After 36.4-month median follow-up, non-frail patients had longer PFS than frail patients, but the PFS benefit of D-Rd versus Rd was maintained across subgroups: non-frail (median, not reached [NR] vs 41.7 months; hazard ratio [HR], 0.48; P<0.0001) and frail (NR vs 30.4 months; HR, 0.62; P=0.003). Improved rates of complete response or better and minimal residual disease (10–5) negativity were observed for D-Rd across subgroups. The most common grade 3/4 treatment-emergent adverse event in non-frail and frail patients was neutropenia (non-frail, 45.4% [D-Rd] and 37.2% [Rd]; frail, 57.7% and 33.1%). These findings support the clinical benefit of D-Rd in transplant-ineligible NDMM patients enrolled in MAIA, regardless of frailty status.Citation
Facon, T., Cook, G., Usmani, S.Z. et al. Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA. Leukemia, 36, pp. 1066–1077. https://doi.org/10.1038/s41375-021-01488-8Publisher
Springer NatureJournal
LeukemiaAdditional Links
https://www.nature.com/articles/s41375-021-01488-8Type
Journal articleLanguage
enDescription
© 2022 The Authors. Published by Springer Nature. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1038/s41375-021-01488-8ISSN
0887-6924ae974a485f413a2113503eed53cd6c53
10.1038/s41375-021-01488-8
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Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/