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Adding daratumumab to standard treatment for Multiple Myeloma increases progression-free survival

Myeloma cells producing monoclonal proteins of varying types – Illustration credit Scientific Animations via Wikipedia

CANCER DIGEST – Feb. 2, 2024 – Adding the drug daratumumab (Darzalex®) to standard treatment substantially increased survival in patients with multiple myeloma, results of a large randomized clinical trial has shown.

The international PERSEUS trial enrolled 709 newly diagnosed multiple myeloma patients at dozens of cancer centers in Europe and randomly assigned them to a standard therapy combination of Bortezomib, Lenalidomide, and Dexamethasone or to the standard combination plus Daratumumab. 

All patients were eligible for stem cell transplantation. The trial results appear in the Jan. 25, 2024 New England Journal of Medicine.

After a median follow up of 47.5 months 67.7 percent of the standard therapy group survived without their cancer progressing compared to 84 percent of the daratumumab group. In addition, when tested for signs of cancer using a sensitive DNA test, 75 percent of the daratumumab patients tested negative or were cancer-free compared to 48 percent of the standard therapy group.

Multiple myeloma is cancer of the bone marrow and plasma cells. Daratumumab is in a class of medications called monoclonal antibodies. It works by helping the body to slow or stop the growth of cancer cells.

The overall 60 percent drop in risk of cancer progression or death was called unprecedented by lead author of the study Pieter Sonneveld, M.D., Ph.D of Erasmus MC Cancer Institute, Rotterdam, Netherlands.

Side effects among the daratumumab group included increased infections, lower immune blood cell counts and lower clotting or plasma cell counts. There were slightly fewer patients (4 percent)  in the daratumumab group who died of complications of the treatment compared to 5 percent of patients in the standard group.

The ongoing trial will track patients to see how long they survive to determine overall survival.

Sources: National Cancer Institute blog and New England Journal of Medicine

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