Nizar J. Bahlis, MD, associate professor at University of Calgary, Alberta, Canada, discusses updated data from the phase 3 MAIA trial in multiple myeloma.

The MAIA trial evaluated daratumumab (Darzalex), lenalidomide (Revlimid), and dexamethasone (DRd) versus lenalidomide and dexamethasone (Rd) alone in patients with transplant-ineligible multiple myeloma, approximately half of which were over the age of 75.

According to the updated findings, the progression-free survival (PFS) continued to favor DRd. The median PFS with DRd was still not reached with 68% of the patients remaining progression free, says Bahlis. This compared with a median PFS of 33 months in the control arm. The hazard ratio remains the same at 0.5, translating to a 44% reduction in the risk of death with DRd.

Notably, the complete response (CR) rate deepened with DRd with longer-term follow-up. Nearly 50% of patients achieved a CR or better. Additionally, minimal residual disease (MRD) negativity at a sensitivity of 10-5 rose from 24% to 29%. Longer-term follow-up confirmed that 15% of patients experienced sustained MRD negativity at 6 months, adds Bahlis.

PFS2 also favored DRd with a median PFS2 that has yet to be reached versus 46 months in the control arm. No new toxicities or treatment-emergent adverse effects have been reported with longer term follow-up, adds Bahlis. The results for overall survival are eagerly anticipated this year, concludes Bahlis.

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Nizar J. Bahlis, MD, discusses updated data from the phase 3 MAIA trial in multiple myeloma.

Dr. Bahlis on Updated Data From the MAIA Trial in Multiple Myeloma

Nizar J. Bahlis, MD, associate professor at University of Calgary, Alberta, Canada, discusses updated data from the phase 3 MAIA trial in multiple myeloma.

The MAIA trial evaluated daratumumab (Darzalex), lenalidomide (Revlimid), and dexamethasone (DRd) versus lenalidomide and dexamethasone (Rd) alone in patients with transplant-ineligible multiple myeloma, approximately half of which were over the age of 75.

According to the updated findings, the progression-free survival (PFS) continued to favor DRd. The median PFS with DRd was still not reached with 68% of the patients remaining progression free, says Bahlis. This compared with a median PFS of 33 months in the control arm. The hazard ratio remains the same at 0.5, translating to a 44% reduction in the risk of death with DRd.

Notably, the complete response (CR) rate deepened with DRd with longer-term follow-up. Nearly 50% of patients achieved a CR or better. Additionally, minimal residual disease (MRD) negativity at a sensitivity of 10-5 rose from 24% to 29%. Longer-term follow-up confirmed that 15% of patients experienced sustained MRD negativity at 6 months, adds Bahlis.

PFS2 also favored DRd with a median PFS2 that has yet to be reached versus 46 months in the control arm. No new toxicities or treatment-emergent adverse effects have been reported with longer term follow-up, adds Bahlis. The results for overall survival are eagerly anticipated this year, concludes Bahlis.

Nizar J. Bahlis, MD, associate professor at University of Calgary, Alberta, Canada, discusses daratumumab (Darzalex) plus lenalidomide (Revlimid) and dexamethasone (Rd) in newly diagnosed multiple myeloma (NDMM).

In the phase III MAIA trial, patients who enrolled were ineligible for transplant and treated with a combination of daratumumab plus lenalidomide and dexamethasone, which proved to be superior to Rd alone. With a median follow-up of 28.0 months, the median progression-free survival of the daratumumab arm was not reached compared with 31.9 months (HR, 0.56; 

 <.001) in the control arm. These results represent a new standard of care, says Bahlis.

The 2019 ASH Annual Meeting included a presentation of the LYNX trial, which is looking at re-treatment with daratumumab in combination with carfilzomib (Kyprolis) and dexamethasone in relapsed/refractory myeloma. While daratumumab is being used in the frontline setting, it is hopeful that with future studies data will show that daratumumab can be reused in a subsequent line of therapy, concludes Bahlis.

Nizar J. Bahlis, MD, discusses daratumumab (Darzalex) plus lenalidomide (Revlimid) and dexamethasone in newly diagnosed multiple myeloma.
 
 

Nizar J. Bahlis, MD

Articles

Dr. Bahlis on Updated Data From the MAIA Trial in Multiple Myeloma

Dr. Bahlis on Updated Data From the MAIA Trial in Multiple Myeloma

Dr. Bahlis on Daratumumab Plus Lenalidomide and Dexamethasone in Multiple Myeloma