Dr Costa on the Background of the MASTER Trial in Newly Diagnosed Multiple Myeloma

Luciano J. Costa, MD, PhD, professor, O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham (UAB), discusses the background of the phase 2 MASTER trial (NCT03224507) in newly diagnosed multiple myeloma.

The investigator-initiated MASTER trial evaluated daratumumab (Darzalex), carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (Dara-KRd) as induction therapy in 123 patients with newly diagnosed multiple myeloma, followed by autologous stem cell transplant (ASCT) and up to 8 cycles of Dara-KRd consolidation. Patients were treated between 2018 and 2020, Costa says, and data from the final analysis were presented at the 2023 EHA Congress.

The aim of this trial was to determine the feasibility of implementing minimal residual disease (MRD)–guided consolidation and treatment de-escalation with quadruplet therapy, Costa explains. The study was designed to enrich for high-risk patients, including populations that are underrepresented in most newly diagnosed, transplant-eligible multiple myeloma trials, Costa emphasizes. As such, eligibility criteria included patients over the age of 70 years and those with 2 or more high-risk chromosomal abnormalities, Costa adds.

The study was designed such that patients received 4 cycles of Dara-KRd, followed by ASCT, after which patients could receive up to 8 cycles of Dara-KRd consolidation, Costa continues. Treatment following transplant was determined by MRD status. Patients who had two consecutive MRD-negative assessments were able to stop therapy and underwent MRD surveillance, Costa concludes.