Subcutaneous Daratumumab Provides “Win-Win” in NDMM Maintenance

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Patients with high-risk markers may especially benefit from the addition of daratumumab to lenalidomide as maintenance therapy for NDMM.

Adding subcutaneous daratumumab (Darzalex) to maintenance therapy for newly diagnosed multiple myeloma (NDMM) may improve patient quality of life, according to Larry Anderson, MD, PhD, FACP.

In a conversation with CancerNetwork® at the 22nd International Myeloma Society (IMS) Annual Meeting, Anderson spoke about findings from the phase 3 AURGIA trial (NCT03901963) assessing maintenance therapy with subcutaneous daratumumab plus lenalidomide (Revlimid) vs lenalidomide alone in patients with minimal residual disease (MRD) positivity following autologous stem cell transplant. According to findings that Anderson presented, the rates of MRD-negative conversion at a sensitivity of 10–5 were 60.6% with daratumumab/lenalidomide vs 28.7% with lenalidomide alone (OR, 3.92; 95% CI, 2.16-7.14; P < .0001).

Anderson noted that the addition of daratumumab may especially benefit patients with certain factors, such as IMS 2024 high-risk disease. Additionally, he said that subcutaneous daratumumab would improve quality of life over intravenous infusion by giving hours back to patients that they normally had to reserve for treatment at the infusion chair.

Anderson is a professor in the Department of Internal Medicine and a member of the Division of Hematology and Oncology at the University of Texas (UT) Southwestern Medical Center as well as director of the Myeloma, Waldenström’s, and Amyloidosis Program; leader of the Hematologic Malignancies and Cellular Therapy Clinical Research Program; codirector of the Phase I Clinical Trial Research Program; and codirector of the Cellular Immunotherapy and Autologous Stem Cell Transplant Program at the UT Southwestern Harold C. Simmons Comprehensive Cancer Center in Dallas.

Transcript:

In general, [for] patients who are still MRD positive after their frontline induction therapy and transplant, we’re recommending the addition of daratumumab to their lenalidomide. More specifically, in patients who have high-risk chromosomes, those patients particularly benefit from the addition of other therapies to their lenalidomide. For example, daratumumab and lenalidomide, carfilzomib and lenalidomide, or other options, especially for these modified IMS 2024 high-risk patients who have 2 or more markers that are high risk.

Giving this daratumumab subcutaneously in this study allows these patients to have a better quality of life. They’re not stuck in the infusion chair for hours waiting for their [infusion] to get started. They don’t have to have [intravenous] infusions other than their zoledronic acid [Zometa] periodically, things like that. They have less time in the infusion chair and more time spending time doing things they like. Our infusion chairs are freed up for other patients to get more patients in for their maintenance therapy. It’s a win-win.

Reference

Anderson L, Chung A, Foster L, et al. Updated efficacy and safety results of subcutaneous daratumumab plus lenalidomide versus lenalidomide alone as maintenance therapy in newly diagnosed multiple myeloma after transplant: AURIGA study. Abstract presented at: 22nd International Myeloma Society Annual Meeting; September 17-20, 2025; Toronto, ON, Canada. Abstract OA-47.

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