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ORIGINAL RESEARCH article
Front. Hematol.
Sec. Blood Cancer
Volume 3 - 2024 |
doi: 10.3389/frhem.2024.1438233
REAL-LIFE EXPERIENCE WITH FIRST-LINE TREATMENT WITH DARATUMUMAB, BORTEZOMIB, MELPHALAN, AND PREDNISONE IN PATIENTS WITH NEWLY DIAGNOSED MULTIPLE MYELOMA INELIGIBLE FOR AUTOLOGOUS STEM-CELL TRANSPLANTATION
Provisionally accepted
Amalia Domingo-González
1*
Rafael Alonso Fernández
2
Ana Jiménez
3
Teresa De Soto Álvarez
4*
Ana Lerma
5*
Virginia Pradillo Fernández
6*
Gonzalo Benzo Callejo
7*
Jose Sánchez-Pina
2*
Elena Landete
8*
Alberto Velasco
9*
Marina Menéndez Cuevas
9*
Mónica María López Riñón
10*
Andrés Ramírez López
11*
María-Jesús Blanchard
3*
Elham Askari
1*- 1 Department of Hematology and Hemotherapy, University Hospital Jiménez Díaz Foundation, Madrid, Spain
- 2 Department of Hematology and Hemotherapy, University Hospital October 12, Madrid, Asturias, Spain
- 3 Department of Hematology, Ramón y Cajal University Hospital, Madrid, Madrid, Spain
- 4 Department of Hematology, University Hospital La Paz, Madrid, Asturias, Spain
- 5 Department of Hematology, Hospital General Nuestra Señora Del Prado, Toledo, Spain
- 6 Department of Hematology, Hospital Universitario Quirón Pozuelo, Madrid, Spain
- 7 Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain
- 8 Department of Hematology, University Hospital Infanta Leonor, Madrid, Spain
- 9 Department of Hematology, Hospital Rey Juan Carlos, Madrid, Asturias, Spain
- 10 Department of Hematology, Hospital General de Tomelloso, Ciudad Real, Spain
- 11 Department of Hematology, Hospital General La Mancha Centro, Ciudad Real, Spain
The regimen with daratumumab, bortezomib, melphalan, and prednisone (D-VMP) is one of the recommended treatments for newly diagnosed multiple myeloma (NDMM) non-transplant eligible due to the results described in the ALCYONE trial. However, real-life outcomes with this regimen are limited. This study assesses the real-life effectiveness and safety of this regimen. We retrospectively analyzed the data on efficacy, safety, and survival parameters of D-VMP regimen in 112 patients with NDMM not eligible for autologous stem-cell transplantation with attention to the effect of age, R2-ISS, high-risk cytogenetic abnormalities (CA), and depth of response. Patients aged ≥75 years constituted 70% of our cohort. Fifty-two percent had R2-ISS 3-4, and 60% had high-risk CA. Twenty-three percent of patients would have been excluded from the ALCYONE trial. After a median follow-up of 31.4 months, all patients had completed induction, with a median number of cycles of 9 (IQR 6-9). The overall response rate was 95%, and 72% achieved very good partial response (VGPR) or better. The median progression-free survival (PFS) was 41.5 (95% CI, 34.3 to NE), and the median overall survival (OS) was not reached. The most frequent adverse event (AE) was neuropathy (27%), followed by gastrointestinal symptoms (13%) and hematological AE (10%). Age did not negatively impact survival outcomes. Patients with ≥2 high-risk CA or those who achieved
Keywords: Multiple Myeloma, Newly diagnosed multiple myeloma, non-transplant candidates, Daratumumab, Bortezomib, melphalan and prednisone, real-life
Received: 25 May 2024; Accepted: 23 Aug 2024.
Copyright: © 2024 Domingo-González, Alonso Fernández, Jiménez, De Soto Álvarez, Lerma, Pradillo Fernández, Benzo Callejo, Sánchez-Pina, Landete, Velasco, Menéndez Cuevas, López Riñón, Ramírez López, Blanchard and Askari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Amalia Domingo-González, Department of Hematology and Hemotherapy, University Hospital Jiménez Díaz Foundation, Madrid, Spain
Teresa De Soto Álvarez, Department of Hematology, University Hospital La Paz, Madrid, 28046, Asturias, Spain
Ana Lerma, Department of Hematology, Hospital General Nuestra Señora Del Prado, Toledo, Spain
Virginia Pradillo Fernández, Department of Hematology, Hospital Universitario Quirón Pozuelo, Madrid, Spain
Gonzalo Benzo Callejo, Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain
Jose Sánchez-Pina, Department of Hematology and Hemotherapy, University Hospital October 12, Madrid, 28041, Asturias, Spain
Elena Landete, Department of Hematology, University Hospital Infanta Leonor, Madrid, Spain
Alberto Velasco, Department of Hematology, Hospital Rey Juan Carlos, Madrid, Asturias, Spain
Marina Menéndez Cuevas, Department of Hematology, Hospital Rey Juan Carlos, Madrid, Asturias, Spain
Mónica María López Riñón, Department of Hematology, Hospital General de Tomelloso, Ciudad Real, Spain
Andrés Ramírez López, Department of Hematology, Hospital General La Mancha Centro, Ciudad Real, Spain
María-Jesús Blanchard, Department of Hematology, Ramón y Cajal University Hospital, Madrid, Madrid, Spain
Elham Askari, Department of Hematology and Hemotherapy, University Hospital Jiménez Díaz Foundation, Madrid, Spain
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