Recently, researchers noted that no studies directly compare bortezomib-lenalidomide-dexamethasone (VRd) and daratumumab plus bortezomib-thalidomide-dexamethasone (D-VTd) in patients with multiple myeloma (MM), both of which are guideline-recommended induction therapy regimens.
The study’s authors ultimately supported using a quadruplet regimen with a CD38 monoclonal antibody over the triplet regimen as front-line induction therapy to achieve adequate disease control among transplant-eligible patients with MM. Findings from the study were published in Blood Research.
D-VTd Versus VRd for Disease Control
The study included 37 patients treated with VRd and 43 treated with D-VTd between November 2020 and December 2021. All patients were over 18 years old and underwent autologous stem cell transplantation after induction therapy. Responses and safety outcomes were compared between the groups.
Researchers reported the following response outcomes per group:
| VRd | D-VTd | |
| Stringent complete remission | 10.8% | 9.3% |
| Complete remission | 21.6% | 34.9% |
| Very good partial response | 35.1% | 48.8% |
| Partial response | 32.4% | 4.2% |
In addition, 67.6% of patients in the VRd group achieved a very good partial response or better compared with 90.5% of patients in the D-VTd group (P=.004).
After transplantation, 68.6% of patients in the VRd group achieved stringent complete remission or complete response compared with 90.5% of patients in the D-VTd group (P=.016). Lastly, VRd was associated with an increased incidence of skin rash events (P=.044), though the authors noted no other significant differences in adverse events.
To conclude, the authors suggested, “Our study supports the use of a front-line quadruplet induction regimen containing a CD38 monoclonal antibody for transplant-eligible patients with newly diagnosed MM.”
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