Dr. Moreau on the CASSIOPEIA Trial in Transplant-Eligible Myeloma

Phillippe Moreau, MD, head, Hematology Department, university professor of clinical hematology, University Hospital of Nantes, France, discusses the phase III CASSIOPEIA trial in transplant-eligible multiple myeloma.

For young fit patients, induction therapy with bortezomib (Velcade), thalidomide, and dexamethasone (VTd) followed by autologous stem cell transplantation (ASCT) and VTd consolidation is standard of care. In the pivotal CASSIOPEIA trial, investigators sought to enhance the current standard of care by evaluating the addition of daratumumab (Darzalex) to induction and consolidation therapy with the triplet.

In the first part of the trial, 1085 patients were randomized to receive induction and consolidation with daratumumab/VTd or VTd alone. Findings demonstrated that the rate of stringent complete response among patients treated with the quadruplet was 28.9% versus 20.3% in those treated with VTd alone. Patients who received the quadruplet also experienced an improvement in progression-free survival (HR, 0.47). Based on these data, the FDA granted a priority review to the supplemental biologics license application for the quadruplet therapy in transplant-eligible patients. The agency is expected to make its decision by September 26, 2019.