Department of Oncology and Hematology, University Medical Center of Hamburg-Eppendorf, Hamburg, Germany.
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Leuk Lymphoma. 2022 Aug;63(8):1887-1896. doi: 10.1080/10428194.2022.2047962. Epub 2022 Mar 15.
Given the increasing use of frontline lenalidomide-based therapies in multiple myeloma (MM), there is an emerging need for lenalidomide-sparing regimens at relapse. Carfilzomib plus dexamethasone and daratumumab (KdD) and daratumumab plus bortezomib and dexamethasone (DVd) are lenalidomide-sparing triplet regimens that are approved for relapsed and/or refractory MM (R/RMM). In the absence of a head-to-head trial comparing these treatments, a matching-adjusted indirect treatment comparison (MAIC) was conducted to assess the efficacy and safety of KdD versus DVd. Results showed that treatment with KdD decreases the risk of progression or death versus DVd (HR 0.64; 95% confidence interval (CI): 0.46-0.90). Time-dependent analysis demonstrated a larger benefit for KdD after the first eight cycles. Unmatched subgroup analysis indicated that KdD may be particularly effective in lenalidomide-exposed and -refractory patients. The present analysis suggests that KdD improves outcomes compared with DVd in patients with R/RMM and may provide a rationale for a preferential treatment.
鉴于在多发性骨髓瘤（MM）中越来越多地使用一线来那度胺为基础的疗法，在复发时需要出现新的来那度胺节省方案。卡非佐米联合地塞米松和达雷妥尤单抗（KdD）和达雷妥尤单抗联合硼替佐米和地塞米松（DVd）是批准用于复发和/或难治性 MM（R/RMM）的来那度胺节省三联方案。由于没有比较这些治疗方法的头对头试验，因此进行了匹配调整间接治疗比较（MAIC），以评估 KdD 与 DVd 的疗效和安全性。结果表明，与 DVd 相比，KdD 治疗可降低进展或死亡的风险（HR 0.64；95%置信区间[CI]：0.46-0.90）。时间依赖性分析表明，在头 8 个周期后，KdD 的获益更大。未匹配的亚组分析表明，KdD 可能对来那度胺暴露和难治性患者特别有效。本分析表明，KdD 可改善 R/RMM 患者的预后，与 DVd 相比，KdD 可能为首选治疗提供了依据。
