SCIENTIFIC PROGRAMME
SESSION I
HOW I TREAT
SMOLDERING MYELOMA
(SMM)
SESSION II
HOW I TREAT NEWLY
DIAGNOSED MULTIPLE
MYELOMA
SESSION III
FROM RISK
STRATIFICATION TO
RISK-BASED THERAPY?
DEBATE 1
SHOULD WE USE MRD
TESTING TO DETERMINE
THERAPY IN MULTIPLE
MYELOMA?
DEBATE 2
IS THERE A FUTURE ROLE
OF AUTOLOGOUS STEM
CELL TRANSPLANTATION?
SESSION IV
HOW I TREAT RELAPSED
MULTIPLE MYELOMA
DEBATE 3
SHOULD EVERY PATIENT
RECEIVE DARATUMUMAB
IN FIRST LINE?
ROUNDTABLE
MULTIPLE MYELOMA
FROM THE PERSPECTIVE
OF FDA/EMEA AND
FOUNDATIONS
SESSION V
YOU CAN’T BE IMMUNE
FOR IMMUNE THERAPY
ANYMORE
SESSION VI
OTHER PLASMA CELL
DYSCRASIAS
KEYNOTE LECTURES
THE FUTURE OF
MULTIPLE MYELOMA
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
ABSTRACTS SELECTED
AS POSTERS
DISCLOSURES
PHILIPPE MOREAU (NANTES)
SHOULD EVERY PATIENT RECEIVE DARATUMUMAB IN FIRST LINE?
YES
University Hospital Hôtel-Dieu, Nantes, France
For fit newly-diagnosed multiple myeloma (NDMM) patients, up to the age of 70 years, without
comorbidities, induction followed by high-dose therapy (HDT) with autologous stem cell
transplantation (ASCT) and lenalidomide maintenance is the recommended treatment. The
introduction of monoclonal antibodies (MAbs) and especially of daratumumab in the frontline setting
is changing the treatment landscape. In the phase 3 CASSIOPEIA trial, four cycles of induction with
bortezomib thalidomide and dexamethasone VTD (n=542) were compared with four cycles of VTD plus
daratumumab (DaraVTD; n=543); patients then received a single ASCT followed by consolidation and
maintenance. Progression-free survival (PFS) at 18 months showed a superiority of DaraVTD (93% vs.
85%, P<0.0001) 1. The combination of daratumumab (Dara) with bortezomib lenalidomide and
dexamethasone (VRD) seems to produce even better results. In the randomized, phase 2 GRIFFIN
study, 207 patients were randomized to receive VRD±Dara induction (4 cycles), ASCT, VRd±Dara
consolidation (2 cycles), and lenalidomide±Dara maintenance (26 cycles). The 24-month PFS rates were
95.8% for Dara-VRd and 89.8% for VRd 2. The approval of DaraVTD in Europe makes it as new
standard of care for induction before ASCT.
In NDMM patients who are not eligible for ASCT, the addition of daratumumab to bortezomib
melphalan and prednisone VMP and lenalidomide and low-dose dexamethasone Rd has created two
new standards of care. Dara-VMP and Dara-Rd were approved by EMA in October 2019, based on the
results of two large phase 3 studies. In the ALCYONE study, 706 patients with NDMM who were
ineligible for ASCT were randomized to receive nine cycles of VMP either alone or with daratumumab
(Dara-VMP); then daratumumab was given until disease progression. At a median follow-up of 40
months, the median PFS was 36.4 vs. 19.3 months for Dara-VMP and VMP arms, respectively, while
the 36-month rate of OS was 78% in the Dara-VMP group and 68% in the VMP group (HR: 0.60;
P=0·0003) 3. In the MAIA study, 737 NDMM patients who were ineligible for ASCT were randomized
to receive either Dara-Rd or Rd until disease progression. At a median follow-up of 28 months, the
estimated percentage of PFS at 30 months was 70.6% in the Dara-RD group and 55.6% in the Rd group
(HR: 0.56; P<0.001) 4. The efficacy data of the MAIA study are the best ever reported in patients not
eligible for ASCT.
1 - Moreau P, Attal M, Hulin C et al. Bortezomib, thalidomide, and dexamethasone with or without
daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple
myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet 2019; 394: 29-38.
2 - Voorhees PM, Kaufman JL, Laubach JP et al. Daratumumab, lenalidomide, bortezomib, and
dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood 2020;
136:936-945.
3 - Mateos MV, Cavo M, Blade J et al. Overall survival with daratumumab, bortezomib, melphalan, and
prednisone in newly diagnosed multiple myeloma (ALCYONE): a randomised, open-label, phase 3 trial.
Lancet 2020; 395:132-141.
4 - Facon T, Kumar S, Plesner T et al. Daratumumab plus Lenalidomide and Dexamethasone for Untreated
Myeloma. N Engl J Med 2019; 380: 2104-2115.