Dr. Landgren on the Clinical Impact of KRd-D in Multiple Myeloma

Ola Landgren, MD, PhD, the inaugural leader of the Experimental Therapeutics Program at Sylvester Comprehensive Cancer Center, Miami Health System, discusses the clinical impact of the 4-drug combination of carfilzomib (Kyprolis), lenalidomide (Revlimid), dexamethasone, and daratumumab (Darzalex; KRd-D) in patients with multiple myeloma.

Results from the phase 2 MANHATTAN trial, which examined the quadruplet in patients with newly diagnosed multiple myeloma, yielded high rates of minimal residual disease (MRD) negativity and progression-free survival. Deep responses can be achieved through modern therapy in the absence of a bone marrow transplant, according to Landgren. Additionally, a once weekly administration of the quadruplet is reasonable for a defined period of time, he notes. However, going forward, it is not known whether every patient will need a full 8 cycles of therapy. When examining the median time to MRD negativity, patients enrolled on the trial achieved MRD negativity with 1 to 6 cycles of therapy. The median time to MRD negativity was 6 cycles, Landgren explains.

Compared with other available options, such as bone marrow transplant, which is associated with toxicities and sustained peripheral neuropathy, a once weekly infusion of the quadruplet is a positive prospective treatment, Landgren says. KRd-D is pushing the field forward and offers a new option for this patient population, Landgren concludes.