Efficacy and Safety of Daratumumab, Pomalidomide, and Dexamethasone (DPd) Compared to Daratumumab, Bortezomib, and Dexamethasone (DVd) in Daratumumab–Naïve Relapsed Multiple Myeloma

SIMPLE SUMMARY: We have been studying different combinations of medications to treat relapsed or refractory multiple myeloma. Among these combinations, one includes daratumumab with pomalidomide and dexamethasone (DPd), and another includes daratumumab with bortezomib and dexamethasone (DVd). So far, there have not been any direct comparisons performed through a clinical trial. In our analysis, we found that the DPd group had more patients with high-risk disease characteristics. Interestingly, the DPd group showed a better response to treatment. However, when we looked at the time until the disease progressed and overall survival, we found that these were similar between the two groups. It is important to note that we should be cautious in drawing conclusions from these findings because there were differences in the characteristics of the patients and lengths and durations of treatment, and the number of patients in both treatment groups was relatively small. Our study highlights the importance of considering factors like the type of patients, the side effects of the medications, and the characteristics of the disease when deciding which treatments to use. It is crucial to personalize the treatment approach for each individual based on these factors. ABSTRACT: Daratumumab-based combinations with pomalidomide/dexamethasone (DPd), or bortezomib/dexamethasone (DVd), have shown activity in relapsed/refractory multiple myeloma (RRMM) patients. However, no direct comparisons of safety or efficacy of the two regimens have been published to date. We conducted a retrospective study to compare the safety and efficacy of DPd and DVd in daratumumab-naïve RRMM patients. We included 140 daratumumab-naïve patients who had received DPd or DVd for RRMM. Overall, the DPd group had a greater number of patients who had high-risk disease characteristics. Although response was deeper in the DPd group, the median progression-free survival (PFS) and overall survival (OS) were similar between the two groups. The DPd group exhibited a higher incidence of hematologic toxicities, whereas the DVd group had a higher incidence of peripheral neuropathy. The study results showed that while DPd may provide a deeper response, there was no significant difference in PFS or OS compared to DVd. For the high proportion of difficult-to-treat patients, duration of treatment may have contributed to these results, indicating that patient and disease characteristics should be considered when selecting salvage treatments.