Dr. Silbermann on the CASTOR Trial in Relapsed/Refractory Myeloma

Rebecca Silbermann, MD, MMS, an assistant professor of medicine, Division of Hematology/Medical Oncology, School of Medicine, Oregon Health & Science University, discusses the phase 3 CASTOR trial in relapsed/refractory multiple myeloma.

The CASTOR study enrolled 498 patients, says Silbermann. Data were initially presented at the end of 2015 and were published in 2016; they showed that the combination of daratumumab (Darzalex), bortezomib (Velcade), and dexamethasone was beneficial for patients who had received at least 1 prior line of therapy and achieved at least a partial response to that treatment. Patients who were refractory to proteasome inhibitors were excluded from the study.

The initial analysis had a median follow-up of 7.4 months, adds Silbermann. The more recent data provided a median of 40 months of follow-up, and also included a subgroup analysis on standard-risk versus high-risk patients and how those patients did with the regimen. Results showed that even patients with high-risk disease did well with the approach, and they experienced a significant improvement in progression-free survival (PFS) for the daratumumab combination arm. The median PFS in the standard-risk patients was about 16.7 months with the triplet versus 7.1 months for the doublet combination, concludes Silbermann.