Dr. Mailankody on CASSIOPEIA Results in Newly Diagnosed Multiple Myeloma

Sham Mailankody, MBBS, assistant attending physician, Memorial Sloan Kettering Cancer Center, discusses results of the CASSIOPEIA trial in patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant.

The most recent standard of care for multiple myeloma has been triplet combinations, the most common one in the United States being lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (VRd), explains Mailankody. Another common triplet regimen is thalidomide (Thalomid), bortezomib, and dexamethasone (VTd), which is more common in Europe, says Mailankody.

The CASSIOPEIA trial examines adding daratumumab (Darzalex) to the VTd combination to create a quadruplet therapy. The reasoning behind adding daratumumab, according to Mailankody, is that adding a fourth drug could improve responses, similar to how 3 drugs was better than 2 drugs when evaluating triplet regimens. The CASSIOPEIA study showed an improvement in response rate and progression-free survival, leading to FDA approval for daratumumab plus VTd quadruplet in September 2019. Further research must be done to see how the addition of daratumumab affects other 3-drug regimens, including VRd and carfilzomib (Kyprolis)/lenalidomide/dexamethasone, concludes Mailankody.