Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis.
Thierry Facon, Shaji K Kumar, Robert Z Orlowski et al.
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In 30 seconds
The MAIA randomised controlled trial compared daratumumab plus lenalidomide and dexamethasone (D-Rd) with lenalidomide and dexamethasone (Rd) in transplant-ineligible adults with newly diagnosed multiple myeloma. In this final survival analysis, after a median follow-up of 89.3 months, median overall survival was 90.3 months with D-Rd versus 64.1 months with Rd (hazard ratio, 0.67; 95% CI, 0.55-0.82). Estimated 7-year survival was also higher with D-Rd. The analysis additionally found a longer time to subsequent antimyeloma treatment with D-Rd.
Key findings
- Median overall survival was 90.3 months with D-Rd versus 64.1 months with Rd (hazard ratio, 0.67; 95% CI, 0.55-0.82).
- Estimated 7-year overall survival was 53.1% (95% CI, 47.8-58.2) with D-Rd and 39.3% (34.1-44.5) with Rd.
- Median time to subsequent antimyeloma treatment was not reached with D-Rd versus 42.4 months (33.5-50.6) with Rd (hazard ratio, 0.51; 95% CI, 0.41-0.63; P < 0.0001).
- Deaths due to adverse events occurred in 44/364 patients (12%) with D-Rd and 40/365 (11%) with Rd.
Why it matters
Long-term survival is a central outcome for people with newly diagnosed myeloma who are not eligible for transplantation. These results show that the survival advantage previously reported for D-Rd versus Rd persisted with extended follow-up, alongside a longer interval before subsequent antimyeloma treatment. The findings provide useful evidence on the durability of outcomes with these frontline regimens.
What to keep in mind
The abstract reports a randomised trial with extended follow-up but does not describe additional limitations; the final analysis followed a protocol amendment.