Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma

Ajai Chari, Attaya Suvannasankha, Joseph W. Fay, Bertrand Arnulf, Jonathan L. Kaufman, Jainulabdeen J. Ifthikharuddin, Brendan M. Weiss, Amrita Krishnan, Suzanne Lentzsch, Raymond Comenzo, Jianping Wang, Kerri Nottage, Christopher Chiu, Nushmia Z. Khokhar, Tahamtan Ahmadi, Sagar Lonial

Research output: Contribution to journalArticle

172 Scopus citations

Abstract

Daratumumab plus pomalidomide and dexamethasone (pom-dex) was evaluated in patients with relapsed/refractory multiple myeloma with ≥2 prior lines of therapy who were refractory to their last treatment. Patients received daratumumab 16 mg/kg at the recommended dosing schedule, pomalidomide 4 mg daily for 21 days of each 28-day cycle, and dexamethasone 40 mg weekly. Safety was the primary end point. Overall response rate (ORR) and minimal residual disease (MRD) by next-generation sequencing were secondary end points. Patients (N 5 103) received a median (range) of 4 (1-13) prior therapies; 76% received ≥3 prior therapies. The safety profile of daratumumab plus pomdex was similar to that of pom-dex alone, with the exception of daratumumab-specific infusion-related reactions (50%) and a higher incidence of neutropenia, although without an increase in infection rate. Common grade ≥3 adverse events were neutropenia (78%), anemia (28%), and leukopenia (24%). ORR was 60% and was generally consistent across subgroups (58% in double-refractory patients).Amongpatients with a complete response or better, 29% were MRD negative at a threshold of 1025. Among the 62 responders, median duration of response was not estimable (NE; 95% confidence interval [CI], 13.6-NE). At a median follow-up of 13.1 months, the median progression-free survival was 8.8 (95% CI, 4.6-15.4) months andmedian overall survivalwas17.5 (95% CI, 13.3-NE) months.The estimated 12-month survival ratewas 66% (95% CI, 55.6-74.8). Aside from increased neutropenia, the safety profile of daratumumab plus pom-dex was consistent with that of the individual therapies. Deep, durable responses were observed in heavily treated patients.

Original languageEnglish (US)
Pages (from-to)974-981
Number of pages8
JournalBlood
Volume130
Issue number8
DOIs
StatePublished - Aug 24 2017

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Chari, A., Suvannasankha, A., Fay, J. W., Arnulf, B., Kaufman, J. L., Ifthikharuddin, J. J., Weiss, B. M., Krishnan, A., Lentzsch, S., Comenzo, R., Wang, J., Nottage, K., Chiu, C., Khokhar, N. Z., Ahmadi, T., & Lonial, S. (2017). Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma. Blood, 130(8), 974-981. https://doi.org/10.1182/blood-2017-05-785246