A Phase 2 Study of Extended Daratumumab, Carfilzomib, Lenalidomide, and Dexamethasone in Newly Diagnosed Multiple Myeloma

Introduction: The combination of carfilzomib, lenalidomide, and dexamethasone (KRd), with and without autologous stem cell transplantation (ASCT) is an effective regimen for newly diagnosed multiple myeloma (NDMM) (Jakubowiak et al., Blood 2012 and Jasielec et al., Blood 2020). The addition of daratumumab to KRd (Dara-KRd) for 8 cycles led to a measurable residual disease (MRD)-negativity rate of 71% (flow cytometry, limit of detection [LoD] <10 -5); some patients received post-protocol ASCT (Landgren et al., JAMA Oncology, 2021). An MRD-adaptive design of Dara-KRd with ASCT led to high MRD-negativity rates by next generation sequencing (NGS) (Costa et al., EHA 2020). In this phase 2 study, we evaluate the safety and efficacy of extended Dara-KRd without ASCT in patients (pts) with NDMM regardless of transplant eligibility.