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Plasma Cell Disorders
Daratumumab plus bortezomib and dexamethasone versus bortezomib and dexamethasone in relapsed or refractory multiple myeloma: updated analysis of CASTOR
Ferrata Storti Foundation
Andrew Spencer,1 Suzanne Lentzsch,2 Katja Weisel,3 Hervé Avet-Loiseau,4 Tomer M. Mark,5 Ivan Spicka,6 Tamas Masszi,7 Birgitta Lauri,8
Mark-David Levin,9 Alberto Bosi,10 Vania Hungria,11 Michele Cavo,12
Je-Jung Lee,13 Ajay K. Nooka,14 Hang Quach,15 Cindy Lee,16 Wolney Barreto,17 Paolo Corradini,18 Chang-Ki Min,19 Emma C. Scott,20 Asher A. Chanan-Khan,21 Noemi Horvath,16 Marcelo Capra,22 Meral Beksac,23 Roberto Ovilla,24 Jae-Cheol Jo,25 Ho-Jin Shin,26 Pieter Sonneveld,27 David Soong,28
Tineke Casneuf,29 Christopher Chiu,28 Himal Amin,30 Ming Qi,28 Piruntha Thiyagarajah,31 A. Kate Sasser,32 Jordan M. Schecter30 and Maria-Victoria Mateos33
Haematologica 2018 Volume 103(12):2079-2087
1Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, Australia; 2Division of Hematology/Oncology, Columbia University, New York, NY, USA; 3Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II, Tübingen, Germany; 4Unite de Genomique du Myelome, CHU Rangueil, Toulouse, France; 5Department of Medicine, University of Colorado, Aurora, CO, USA; 6Clinical Department of Haematology, 1st Medical Department, Charles University in Prague, Czech Republic; 7Department of Haematology and Stem Cell Transplantation, St László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary; 8Department of Hematology, Sunderbyn Hospital, Luleå, Sweden; 9Albert Schweitzer Hospital Department of Internal Medicine, Dordrecht, the Netherlands; 10Department of Hematology, Careggi Hospital and University of Florence, Italy; 11Irmandade Da Santa Casa De Misericordia De São Paulo, Brazil; 12“Seràgnoli” Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy; 13Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Jeollanamdo, South Korea; 14Winship Cancer Institute, Emory University, Atlanta, GA, USA; 15St. Vincent's Hospital, University of Melbourne, Australia; 16Royal Adelaide Hospital, North Terrace, Australia; 17Hospital Santa Marcelina, São Paulo, Brazil; 18Fondazione IRCCS Instituto Nazionale dei Tumori, University of Milan, Italy; 19Seoul St. Mary’s Hospital, South Korea; 20Oregon Health & Science University, Portland, OR, USA; 21Mayo Clinic Florida, Jacksonville, FL, USA; 22Instituto do Cancer-Hospital Mae de Deus, Porto Alegre, Brazil; 23Ankara University, Turkey; 24Hospital Angeles Lomas, Naucalpan de Juárez y alrededores, México; 25Ulsan University Hospital, South Korea; 26Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea; 27Erasmus Medical Center, Rotterdam, the Netherlands; 28Janssen Research & Development, LLC, Spring House, PA, USA; 29Janssen Research & Development, Beerse, Belgium; 30Janssen Research & Development, LLC, Raritan, NJ, USA; 31Janssen Research & Development, High Wycombe, UK; 32Genmab US, Inc, Princeton, NJ, USA and 33University Hospital of Salamanca/IBSAL, Spain
ABSTRACT
Daratumumab, a CD38 human monoclonal antibody, demonstrat- ed significant clinical activity in combination with bortezomib and dexamethasone versus bortezomib and dexamethasone alone in the primary analysis of CASTOR, a phase 3 study in relapsed and/or refractory multiple myeloma. A post hoc analysis based on treatment his- tory and longer follow up is presented. After 19.4 (range: 0-27.7) months of median follow up, daratumumab plus bortezomib and dexametha- sone prolonged progression-free survival (median: 16.7 versus 7.1 months; hazard ratio, 0.31; 95% confidence interval, 0.24-0.39; P<0.0001) and improved the overall response rate (83.8% versus 63.2%; P<0.0001) compared with bortezomib and dexamethasone alone. The progression-free survival benefit of daratumumab plus bortezomib and dexamethasone was most apparent in patients with 1 prior line of ther- apy (median: not reached versus 7.9 months; hazard ratio, 0.19; 95% con-
Correspondence:
aspencer@netspace.net.au
Received: March 27, 2018. Accepted: August 17, 2018. Pre-published: September 20, 2018.
doi:10.3324/haematol.2018.194118
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/12/2079
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