Frontline Quadruplet Therapy in NDMM: GMMG-HD7
Shared insight on the GMMG-HD7 study, which utilized a frontline isatuximab-containing quadruplet regimen in patients with newly diagnosed multiple myeloma.
Transcript:
Shaji Kumar, MD: Prashant, there are also interesting data with the other anti-CD38 monoclonal antibody, especially from a depth of response standpoint.
Prashant Kapoor, MD: At the ASH [American Society of Hematology] meeting last year, the German group presented data from a phase 3 trial that compared a 4-drug regimen, which involved isatuximab in combination with lenalidomide, bortezomib, and dexamethasone, with VRd [bortezomib, lenalidomide, and dexamethasone]. One of the primary end points of this phase 3 trial was the degree of MRD [minimal residual disease] negativity at the time of transplant, ie, post induction therapy. These were all patients who were transplant eligible, and this study involved over 660 patients. The initial data were impressive in that the quadruplet led to deeper response, based on an MRD-negative rate of approximately 50% with the 4-drug regimen as opposed to 35% or so with the 3-drug regimen. These are just the initial data presented. The trial schema is quite interesting in that it’s a 2-part trial, and post autologous stem cell transplantation, patients would be randomly assigned again to assess the value of adding the anti-CD38 monoclonal antibody to lenalidomide maintenance. In that sense, it’s somewhat different from the GRIFFIN trial that Morie just discussed, because we don’t know whether the value of adding the monoclonal anti-CD38 antibody, in this case daratumumab, is because it was added to the induction, because it was added to the maintenance, or because of the entire regimen pretransplant and post transplant that involved daratumumab. There is more to come; we just need to wait.
Shaji Kumar, MD: Hopefully that will answer the question that Morie was just discussing in terms of use. Do you see any scenario where you would use an isatuximab-VRd combination in the upfront setting?
Prashant Kapoor, MD: I am treating these anti-CD38 monoclonal antibodies as somewhat similar, and I use them interchangeably. There are certain advantages to using daratumumab; for instance, the subcutaneous route of administration makes it much easier for nurses as well as patients. Another advantage is that, especially after 6 months, the frequency of administration is once every 4 weeks as opposed to every 2 weeks for isatuximab.
Transcript edited for clarity.
