Dr. Pianko on the Role of Daratumumab in Frontline Myeloma

Matthew James Pianko, MD, a hematologist and clinical assistant professor at the University of Michigan, discusses the role of daratumumab (Darzalex) in the frontline treatment of multiple myeloma.

The agent's role is an evolving one, Pianko says. The results of the phase 3 MAIA trial (NCT02252172), which examined daratumumab in combination with lenalidomide (Revlimid), and dexamethasone in patients with previously untreated multiple myeloma, led to the FDA approval of the regimen in June 2019. 

Additionally, data from the phase 2 GRIFFIN study (NCT02874742), which examined daratumumab plus lenalidomide, bortezomib (Velcade), and dexamethasone (RVd) in newly diagnosed patients, yielded promising results. The randomized trial identified that the addition of daratumumab to RVd appears to be another viable approach, demonstrating superior depth of response, as well as higher rates of stringent complete response (sCR) vs RVd alone, Pianko says. Additionally, a higher rate of minimal residual disease negativity was observed in patients who received the quadruplet combination, Pianko added.

The study demonstrated that the combination regimen is a feasible approach to treating newly diagnosed patients, in addition to having a positive safety profile. Moreover, stem cell collection did not appear to be compromised by the inclusion of daratumumab in the up-front setting, allowing for successful stem cell collection within the quadruplet arm, Pianko concludes.