PERSEUS: Daratumumab plus VRd in Newly Diagnosed Multiple Myeloma Patients
Luciano Costa, MD, reviews recent data from the PERSEUS trial investigating the combination of daratumumab, bortezomib, lenalidomide and dexamethasone in newly diagnosed multiple myeloma patients.
EP: 1.PERSEUS: Daratumumab plus VRd in Newly Diagnosed Multiple Myeloma Patients
EP: 2.Defining Success in Multiple Myeloma Induction and Maintenance
EP: 3.IsKia: Isatuximab Plus KRd in Pre-Transplant Induction and Post-Transplant Consolidation in TE NDMM
EP: 4.Role of MRD Negativity Rates in Treatment Decision Making
EP: 5.IFM 2018-04: Dara-KRd Induction and Consolidation Plus Double Transplant in HR TE NDMM
EP: 6.Navigating High-Risk Disease in Multiple Myeloma: Treatment Strategies and the Role of ASCT
Summary
Over the past 15 years, the standard triplet regimen of a proteasome inhibitor, an immunomodulatory agent, and steroids has solidified as the foundation of management. Recent trials, including the phase three PERSEUS trial, explore the impact of adding monoclonal antibodies, such as daratumumab, to this regimen in eligible patients for autologous transplant.
The PERSEUS trial, comprising over 700 patients, reveals significant benefits in progression-free survival (PFS) with the addition of Daratumumab to the VRD backbone. Notably, the hazard ratio is 0.42, indicating a substantial reduction in the risk of progression. At 48 months, the median PFS for daratumumab-VRd is 84.3%, compared to 67.7% for VRd alone.
The impact is consistent across subsets, including high-risk disease, demonstrating a higher proportion of patients achieving complete response and minimal residual disease negativity with daratumumab-VRd. While overall survival data are immature, the trial suggests improved depth, quality, and duration of responses.
Toxicity profiles align with expectations for monoclonal antibody additions, with manageable cytopenia and mild respiratory infections. In conclusion, the PERSEUS trial underscores the therapeutic benefits of incorporating daratumumab into induction, consolidation, and maintenance, offering improved outcomes for newly diagnosed multiple myeloma patients eligible for transplant. The findings complement earlier studies and contribute to advancing the standard of care in myeloma treatment.
Summary was AI-generated and edited for clarity and readability.
![“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.](/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fcancernetwork%2F70a5f0fed7009863fe30cf0740cf32014ebaf5be-2974x1660.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 "“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.")
![“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.](/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fcancernetwork%2F267879fc15a40ec8d3ed04d8ee9c1f044b49ee89-2990x1692.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 "“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.")
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