Darzalex proves clinical improvement in primary treatment of multiple myeloma

A domestic study is drawing attention, showing Janssen’s multiple myeloma treatment Darzalex (daratumumab) marked significant clinical improvement in combined therapy of vortezomib+thalidomide+dexamethasone (D-VTd) from the existing standard therapy of vortezomib+lenalidomide+dexamethasone (VRd).

A research team of Professor Byeon Ja-min of the Seoul National University Hospital recently released its study that compared D-VTd and VRd in Blood Research, a journal of the Korean Society of Hematology.

The team said in the study that there had been no research that directly compared D-VTd and VRd recommended as the first treatment after induction therapy, explaining the background for the study that compared the efficacy and safety of the two therapies.

The study was conducted on adult patients with newly diagnosed multiple myeloma among those who could receive autologous stem cell transplantation (ASCT) from November 2020 to December 2021.

As a result, the group administered with VRd therapy as remission-inducing therapy before transplantation showed a strictly complete response (sCR) rate of 10.8 percent, complete response m(CT) of 21.6 percent, and very good partial response (VGPR) of 35.1 percent, and partial response (PR) of 32.4 percent.

In comparison, the D-VT group showed sCR of 9.3 percent, CR of 34.9 percent, VGPR of 48.8 percent, and PR of 4.2 percent.

Afterward, in the case of post-ASCT consolidation administration, 68.6 percent of the VRd group showed CR or sCR, while 90.5 percent of the D-VTd group confirmed CR or sCR.

In side effects, the VTd group showed a relationship with increased incidence of skin rashes, but there were no significant differences between the two groups in other areas.

“This study has confirmed improved responses in the combined therapy of daratumumab after both remission induction and ASCT,” the team said. “Besides, it suggested that the D-VTd group showed more positive data than the VRd group.”

The D-VTd group also confirmed improved responses in situations where the elderly and many renal failure patients.

Commenting on this, the team explained that it had already been known that thalidomide shows fewer side effects than lenalidomide. It added that as up to 50 percent of multiple myeloid patients also have a renal failure when visiting the hospital, the study showed that the D-VTd therapy is a more effective option for patients with renal insufficiency.

It also emphasized that the study showed that although the D-VTd treatment is the fourth therapy, it has relatively fewer side effect issues. When Darzalex was used as a follow-up treatment, there was a possibility of lymphocyte reduction and subsequent infection. However, the study added that existing side effects were not identified when Dazalex was used on a limited basis in an environment with no treatment experience.