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Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: Frailty subgroup analysis of MAIA

Facon, Thierry
; 
Cook, Gordon
; 
Usmani, Saad Z.
; 
Hulin, Cyrille
; 
Kumar, Shaji
; 
Plesner, Torben
; 
Touzeau, Cyrille
; 
Bahlis, Nizar
; 
Basu, Supratik
; 
Nahi, Hareth
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Authors
Facon, Thierry
 Cook, 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
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2022-01-02
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Subjects
myeloma
 frailty
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Abstract
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/s41375-021-01488-8
Publisher
Springer Nature
Journal
Leukemia
Research Unit
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http://hdl.handle.net/2436/624460
DOI
10.1038/s41375-021-01488-8
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https://www.nature.com/articles/s41375-021-01488-8
Type
Journal article
Language
en
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© 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/s41375-021-01488-8
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0887-6924
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