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March 30, 2025
Expanding Horizons in Multiple Myeloma: CD38 Antibodies in Transplant-Eligible Patients

The FDA recently approved daratumumab and hyaluronidase-fihj (subcutaneous CD38 antibody) in combination with bortezomib, lenalidomide, and dexamethasone (VRd) for induction and consolidation in newly diagnosed multiple myeloma (MM) patients eligible for autologous stem cell transplant (ASCT). The approval was based on clinical trial results (NCT03710603) that demonstrated a significant reduction in disease progression or death by 60% with CD38-VRd compared to VRd alone. Common adverse reactions included neuropathy, fatigue, and upper respiratory infections, among others. The efficacy and tolerability of CD38 antibodies continue to expand their role in optimizing MM treatment outcomes.

How does the addition of CD38 antibodies reshape the treatment landscape for transplant-eligible multiple myeloma patients? What factors should clinicians consider when selecting induction therapies for this patient population?

  • March 30, 2025
    CD38 antibody combination has become the standard first line treatment for myeloma
  • March 12, 2025
    these are now a standard for first line option so always use them as add on. prefer D-VRD for all
  • March 12, 2025
    anti CD38 has been the backbone of BMT eligible MM pts for a while, I have used D-RVD for a while prior to FDA approval
  • March 12, 2025
    I use DaraVRD as 1st line in transplant eligible patients
  • February 03, 2025
    I think anti-CD38 quads are standard of care at this point for transplant eligible MM patients, and should be used in select transplant ineliglble patients.
  • February 02, 2025
    I have been using DaraVRD in my transplant eligible pts
  • February 01, 2025
    If a patient is transplant eligible, then they would certainly be eligible for this quad therapy. Dara-VRD Is considered the standard of care in transplant, eligible patients. Dara Is very well tolerated, and it really does not add any significant toxicity in the real world when added to VRD so it was not a very difficult addition to our previous triplet induction program
  • January 28, 2025
    I am using a Quad regimen with CD 38 antibodies in the first line setting for transplant eligible and ineligible patients.
  • January 28, 2025
    Dara-VRd has established itself as SOC for frontline in TE patients, except in certain circumstances. Dara is tolerable, convenient and adds a depth of response that was previously not seen. Patients still, however, should go to transplant after initial therapy.
  • January 28, 2025
    Dara-VRd has established itself as SOC for frontline in TE patients, except in certain circumstances. Dara is tolerable, convenient and adds a depth of response that was previously not seen. Patients still, however, should go to transplant after initial therapy.
  • January 27, 2025
    I have been using DVRd to almost all ( except frail/ old and those who cannot toelrate quadruplet due to concern for cytopenias/ poor hepatorenal function etc) regardless of their trasnplant eligible status- and i believe DVRd should be SOC.
  • January 27, 2025
    D-RVD has been now the standard of care in all eligible patients, whether or not they are transplant candidates.
  • January 27, 2025
    For transplant eligible patients, Dara-RVd would be considered the standard of care. This treatment offers the highest response and the most durable PFS. Regardless of the response to treatment, the patient would still benefit from addition of auto transplant for consolidation of gains and to prolong relapse free survival.
    Factors to consider when selecting induction therapies are - transplant eligibility, age, performance status, organ function etc.
  • January 27, 2025
    I believe CD38 Ab should be used in the first setting - either in doublet if poor PS, or triple or quad therapy based on there other co-morbidities and PS
  • January 27, 2025
    This is standard of care for the most part. Dara-VRD
  • January 27, 2025
    I would always use the best therapies for patients upfront so Dara moving up is standard of care and is used. This definitely can have profound downstream impacts on treatment selection in the relapsed setting.
  • January 27, 2025
    Use darzalex for all transplant eligible patients in a quad, and for transplant ineligible in triplet
  • January 27, 2025
    It really seems like old news, as I have been using the quad for years in both transplant eligible and ineligible.
  • January 27, 2025
    today, using a 4 drug regimen consisting of D-VRD with CD 38 inhibitor has been the SOC ofr past 2 yrs
  • January 27, 2025
    Agree with the above comments in that the treatment landscape has essentially transitioned to quadruplet therapy for transplant eligible patients. Would argue that this generally holds true for standard and high risk patients (perhaps with istuximab based and incorporation of carfilzomib if able). Other factors to consider would include concerns with certain agents in particular patient populations (such as bortezomib with neuropathy, carfilzomib with cardiovascular disease, etc).
  • January 27, 2025
    On basically everyone, will start with dara-RVd. Pretty easy decision to make right now, whether going to transplant or not.
  • January 27, 2025
    We have multiple phase 3 studies showing improved efficacy for quads therapy in first line. In my opinion, it should be standard of care to offer all transplant eligible and selected transplant ineligible a quads regimen including anti vd38 antibodies in first line irrespective of cytogenetics.
  • January 27, 2025
    This study confirms the benefit of using a quad regimen in the treatment of myeloma. It is now the standard of care. Factors that may modify this includes performance status, preexisting neuropathy, renal function, molecular profile, etc
  • January 27, 2025
    using this regimen in all comers now, transplant eligibility determined later, mostly for rapid, deep responses to treatment.
  • January 27, 2025
    I have been using Dara-VRd as induction before HDT-ASCT, for almost 3-4 years, very well tolerated with high responce rates and is the standard of care, if they are not transplant eligible using DRD as the preferred regimen, haven't used the quadruplet with Isatuximab in transplant ineligible patients yet.
  • January 27, 2025
    This has already been the standard of practice for many months. I think this just puts the capstone on the standard of care.
  • January 27, 2025
    With approval of Dara-VRd for transplant eligible patients and Isa-VRd for transplant ineligible patients, the quadruplet appears to be the current standard of care over triplets. That stated, it is not clear if the actual survival is superior by giving the anti-CD38 upfront OR if it can be used in the relapse setting which is still a very powerful agent. The phase 3 trials compared Dara/Isa-VRd versus VRd alone and then concluded that the overall survival was superior in the quadruplet. However, they do NOT have any data on VRd triplet followed by an anti-CD38 mAb salvage therapy. Unless ALL of the patients in the Phase 3 control arms received dara as salvage therapy, they cannot state that there is an overall survival advantage.
  • January 27, 2025
    use quad or triplets front line ,higher mrd neg status with combo
  • January 27, 2025
    DRVD has changed the landscape in transplant eligible pts
    i am using this regimen in all eligible pts
  • January 27, 2025
    i think we are starting to use them in the forefront and in 1st line treatment given the data. this will of course lessen it's use in later lines. we need to consider toxicity and also its use with other drugs in combo regimens. also need to consider goals of care as well. logistics are to be considered in terms of administration as it's IV and also sub cu formulations. i believe them to be very effective drugs
  • January 27, 2025
    Dara-VRd is standard of care for induction prior to HDT-ASCT, adopted long before FDA approval.
  • January 27, 2025
    Essentially this is the standard of care. We need to be using quads unless performance status doesn’t allow.
  • January 27, 2025
    I am using CD38 antibodies in the 1st line setting for ALL my myeloma patients. Usually part of a triple or a Quad regimen.
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January 08, 2025
Advancements in Hematology: Long-term Outcomes of Innovative Treatments

In this video, Mikkael A. Sekeres, MD, shares insights from the ASH 2024 meeting on groundbreaking studies in hematology, including promising results for pediatric ALL treatments and the potential of early intervention in myeloma. Dr. Satwanilapur discusses the five-year update on Axocell therapy for indolent lymphoma, demonstrating remarkable long-term survival and remission outcomes. Tune in for the latest breakthroughs in hematologic cancer treatments.

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April 05, 2024
Clinical Outcome of Chemotherapy and Radiation Therapy Versus Chemotherapy, Radiation Therapy, and Multilevel Vertebroplasty or Kyphoplasty for Multiple Myeloma

Clinical Outcome of Chemotherapy and Radiation Therapy Versus Chemotherapy, Radiation Therapy, and Multilevel Vertebroplasty or Kyphoplasty for Multiple Myeloma

Source : https://pubmed.ncbi.nlm.nih.gov/38568002/

This study found that performing kyphoplasty and vertebroplasty in addition to conventional therapy for patients with multiple myeloma resulted in enhanced morbidity and functional outcomes. [ Orthopedics . 202x;4x(x):xx-xx.].

Kyphoplasty and vertebroplasty are cement-augmented techniques that are minimally invasive for the management of osteolytic lesions and associated disabilities in patients with multiple myeloma.

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April 05, 2024
Prevalence and Consequences of a Delayed Diagnosis in Multiple Myeloma: a Single Institution Experience

Prevalence and Consequences of a Delayed Diagnosis in Multiple Myeloma: a Single Institution Experience

Source : https://pubmed.ncbi.nlm.nih.gov/38555259/

A delay in the diagnosis of MM is very frequent in México (68% of cases); despite the fact that there was a significant trend for being in earlier stages of...

Both OS and PFS were similar in the patients diagnosed before or after 3 months from the onset of symptoms.

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January 05, 2024
Cytogenetic Profile in Monoclonal Gammopathy of Undetermined Significance, Smoldering and Symptomatic Multiple Myeloma: a Study of 1087 Patients With Highly Purified Plasma Cells

Cytogenetic Profile in Monoclonal Gammopathy of Undetermined Significance, Smoldering and Symptomatic Multiple Myeloma: a Study of 1087 Patients With Highly Purified Plasma Cells

Source : https://www.mdpi.com/2072-6694/15/23/5690

The aim of this study was to examine the cytogenetic profiles of plasma cell neoplasms (PCNs) at various disease stages, encompassing 1087 patients with monoclonal gammopathy of undetermined significance (MGUS),...

This study demonstrated that >95% of patients exhibited ≥1 cytogenetic abnormality detected by FISH, chromosomal analysis, or both. The frequency of IGH:CCND1 rearrangement was 26% in this cohort, but with no apparent differences across race, age, or disease.