Luciano J. Costa, MD, PhD, discussed the results from the phase 2 GRIFFIN study, designed to evaluate the combination of daratumumab, bortezomib, lenalidomide, and dexamethasone in transplant-eligible patients with multiple myeloma.
As part of CancerNetwork’s Face-Off video series, Luciano J. Costa, MD, PhD, professor of medicine - hematology and oncology, Department of Medicine, University of Alabama at Birmingham, discussed the results from the phase 2 GRIFFIN study (NCT02874742), evaluating daratumumab (Darzalex) in addition to bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (RVd) induction/consolidation therapy along with lenalidomide maintenance in patients with multiple myeloma.
Costa: So, the GRIFFIN study is a trial that took the standard of care in the US for transplant-eligible patients. There was a combination of bortezomib, lenalidomide, and dexamethasone induction, followed by autologous transplant followed by 2 more cycles of bortezomib, lenalidomide, and dexamethasone, followed by lenalidomide maintenance, and compared this standard with the same regimen with the addition of daratumumab [Darzalex]. So, it's VRd versus dara-VRd. And the maintenance was [lenolidomide] versus [daratumumab] for 2 years.
This study was designed in a randomized phase 2 study with about 100 patients in each arm. And the primary end point was stringent [complete response (CR)]. This trial was reported many times before, and met the primary end point. The stringent CR was more frequent, as we would expect with dara-VRd.
Now, what is exciting that has come up on subsequent updates is that the [minimal residual disease (MRD)] negativity rate is also higher with dara-VRd. So, in my opinion that speaks for the depth of response in a more meaningful way, than the stringent CR does. And even though progression-free survival is not the primary end point of that study, the most recent update to that study shows there is also a progression-free survival advantage of dara-VRd over VRd. So, what that means is that we do provide what I consider strong evidence, particularly when taken in context with every other trial done with the addition of monoclonal antibody to establish regimens that consistently show the same thing: deeper, more frequent responses and longer progression-free survival. So I consider that to be a sufficient evidence to call dara-VRd standard of care for newly diagnosed transplant-eligible myeloma patients.
Transcription edited for clarity.
Considering NCCN Guidelines to Determine Maintenance Therapy Multiple Myeloma
February 15th 2025During the 66th American Society of Hematology Annual Meeting and Exposition, experts in multiple myeloma gathered to discuss the impact of maintenance therapy and minimal residual disease (MRD) in patients with newly diagnosed transplant-eligible or -ineligible multiple myeloma.