Review of the final analysis of data from the MASTER clinical trial assessing daratumumab plus carfilzomib, lenalidomide and dexamethasone.
Case: A 54-Year-Old Woman with Newly Diagnosed Multiple Myeloma (NDMM)
Clinical Presentation:
Initial Clinical Workup and Diagnosis:
Treatment:
This is a video synopsis/summary of a Case-Based Peer Perspective featuring: Douglas Sborov, MD.
The phase 2 MASTER trial investigated daratumumab, carfilzomib, lenalidomide, and dexamethasone (DKRd) in transplant-eligible newly diagnosed multiple myeloma. Patients received DKRd induction, autologous stem cell transplant, then 4 cycles of DKRd consolidation. Those achieving minimal residual disease (MRD) negativity twice discontinued treatment; others completed planned DKRd.
Postconsolidation MRD-negativity rates (10-5 threshold) were approximately 80% overall and in subgroups without high-risk cytogenetics, with 1 high-risk abnormality, and with ultra–high-risk disease. MRD-negativity rates (10-6 threshold) were 66% overall but lower in the ultra–high-risk subgroup. Three-year progression-free survival was 66% without high-risk features, 82% with 1 high-risk feature, and 63% with 2 or more high-risk features.
Key conclusions: DKRd is highly effective even in high-risk newly diagnosed transplant-eligible multiple myeloma. MRD-adapted therapy should be explored further in specific populations. Patients with 2 or more high-risk cytogenetic features need improved approaches.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
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