Sustained minimal residual disease negativity in newly diagnosed multiple myeloma and the impact of daratumumab in MAIA and ALCYONE
Open accessAbstract
In patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab reduced the risk of disease progression or death by 44% in MAIA (daratumumab/lenalidomide/dexamethasone [D-Rd]) and 58% in ALCYONE (daratumumab/bortezomib/melphalan/prednisone [D-VMP]). Minimal residual disease (MRD) is a sensitive measure of disease and response to therapy. MRD-negativity status and durability were assessed in MAIA and ALCYONE. MRD assessments using next-generation sequencing (10−5) occurred for patients achieving complete response (CR) or better and after at least CR at 12, 18, 24, and 30 months from the first dose. Progression-free survival (PFS) by MRD status and sustained MRD negativity lasting ≥6 and ≥12 months were analyzed in the intent-to-treat population and among patients achieving at least CR. In MAIA (D-Rd, n = 368; lenalidomide and dexamethasone [Rd], n = 369) and ALCYONE (D-VMP, n = 350; bortezomib/melphalan/prednisone [VMP], n = 356), the median duration of follow-up was 36.4 and 40.1 months, respectively. MRD-negative status and sustained MRD negativity lasting ≥6 and ≥12 months were associated with improved PFS, regardless of treatment group. However, daratumumab-based therapy improved rates of MRD negativity lasting ≥6 months (D-Rd, 14.9% vs Rd, 4.3%; D-VMP, 15.7% vs VMP, 4.5%) and ≥12 months (D-Rd, 10.9% vs Rd, 2.4%; D-VMP, 14.0% vs VMP, 2.8%), both of which translated to improved PFS vs control groups. In a pooled analysis, patients who were MRD negative had improved PFS vs patients who were MRD positive. Patients with NDMM who achieved MRD-negative status or sustained MRD negativity had deep remission and improved clinical outcomes. These trials were registered at www.clinicaltrials.gov as #NCT02252172 (MAIA) and #NCT02195479 (ALCYONE).
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Absence of minimal residual disease has been associated with improved overall survival and progression-free survival in patients with myeloma.
“Such absence of minimal residual disease has been associated with improved overall survival and progression-free survival in patients with myeloma.14-16”
From Teclistamab in Relapsed or Refractory Multiple Myeloma (2022) · cites this paper as [15]
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Current Main Topics in Multiple Myeloma
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- Authors
- San-Miguel, J., Avet-Loiseau, H., Paiva, B., Kumar, S., Dimopoulos, M. A., Facon, T., Mateos, M.-V., Touzeau, C., Jakubowiak, A., Usmani, S. Z., Cook, G., Cavo, M., Quach, H., Ukropec, J., Ramaswami, P., Pei, H., Qi, M., Sun, S., Wang, J., Krevvata, M., DeAngelis, N., Heuck, C., Van Rampelbergh, R., Kudva, A., Kobos, R., Qi, M., & Bahlis, N. J.
- Affiliations
- Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBER-ONC number CB16/12/00369, Pamplona, Spain;
- Unite de Genomique du Myelome, IUC-Oncopole, Toulouse, France;
- Navarre Institute of Health Research (ES)
- Mayo Clinic (US)
- National and Kapodistrian University of Athens (GR)
- Université de Lille (FR)
- Universidad de Salamanca (ES)
- Centre Hospitalier Universitaire de Nantes (FR)
- University of Chicago Medical Center (US)
- Levine Cancer Institute (US)
- University of Leeds (GB)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli,” Università di Bologna, Bologna, Italy;
- The University of Melbourne (AU)
- Janssen Global Medical Affairs, Horsham, PA;
- Janssen Research & Development, LLC, Titusville, NJ;
- Janssen Research & Development (United States) (US)
- Janssen Research & Development, LLC, Spring House, PA;
- Janssen Research & Development, Beerse, Belgium; and
- University of Calgary (CA)
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2022-01-27
- Volume
- 139
- Issue
- 4
- Pages
- 492-501
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC8796656
- OpenAlex
- W3180549397
- Cited by
- 153
- References
- 25
- Citations by year
- 2026: 22 · 2025: 28 · 2024: 39 · 2023: 38 · 2022: 21 · 2021: 4 · 2012: 1
- FWCI
- 16.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- Funders
- National Cancer Institute (P01CA155258)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Keywords
- multiple myeloma, newly diagnosed multiple myeloma, minimal residual disease, daratumumab, progression-free survival, lenalidomide, bortezomib, melphalan, complete response, deep remission, CAR T-cell therapy
- MeSH terms
- Progression-Free Survival, Aged, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Female, Humans, Male, Middle Aged, Multiple Myeloma, Treatment Outcome, Neoplasm, Residual
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