Dr. Nadeem on the Emergence of Quadruplet Regimens in Multiple Myeloma

Omar Nadeem, MD, clinical director, Myeloma Cellular Therapies Program, physician, Dana-Farber Cancer Institute, instructor of medicine, Harvard Medical School, discusses the emergence of quadruplet regimens in multiple myeloma.

Monoclonal antibodies, such as daratumumab (Darzalex), have begun to be incorporated into the frontline treatment of patients with multiple myeloma, says Nadeem.

Historically, triplet combinations demonstrated superiority to doublets in clinical trials for patients with newly diagnosed multiple myeloma, Nadeem says. Now, findings from the phase 3 CASSIOPEIA trial (NCT02541383), which evaluated daratumumab, bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone, as well as the phase 2 GRIFFIN trial (NCT02874742), which evaluated daratumumab, lenalidomide (Revlimid), bortezomib, and dexamethasone, have demonstrated superiority with 4-drug regimens vs their 3-drug counterparts in the setting of transplant-eligible multiple myeloma, Nadeem says.

Notably, quadruplet therapies have demonstrated high rates of stringent complete responses and minimal residual disease negativity, as well as improved progression-free survival and overall survival, compared with triplet therapies in this patient population; however, more mature data are needed for these therapies to become standard frontline options, concludes Nadeem.