Ola Landgren, MD, PhD, discusses the clinical impact of the 4-drug combination of carfilzomib, lenalidomide, dexamethasone, and daratumumab in patients with 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.