Dr. Rajkumar on Quadruplet Regimens in Multiple Myeloma Treatment

S. Vincent Rajkumar, a professor of medicine at the Mayo Clinic, discusses the prevalence of quadruplet regimens in treating patients with multiple myeloma. Choices for patients who experience ≥2 relapses are complicated and quadruplet regimens are stepping in as a viable option for clinicians, says Rajkumar. However, there are considerations to take into account including access to drugs and cost of the therapy.

Promising quadruplet studies include the phase III CASSIOPEIA (MMY3006) trial, which is evaluating the addition of daratumumab (Darzalex) to bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone (VTd) for the treatment of patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant.

The FDA granted a priority review to DVTd based on findings from part 1 of the CASSIOPEIA trial, in which the stringent complete response (sCR) rate at day 100 post-ASCT was 28.9% in patients who received the daratumumab regimen compared with 20.3% in those who received VTd alone following induction and consolidation therapy (odds ratio [OR], 1.60; 95% CI, 1.21-2.12; P =.001). As these data mature, clinicians may see a rise in the use of quadruplet regimens, Rajkumar concludes.

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