Do you recommend utilizing daratumumab in the maintenance phase after a quadruplet induction for transplant eligible multiple myeloma?

Great question as always - both the Phase 2 GRIFFIN study (Dara-VRd vs VRd using IV Dara and 21-day induction cycles) and the Phase 3 PERSEUS study (Dara-VRd vs VRd using subQ dara and 28-day induction cycles) went on to use dara + lenalidomide for all patients in the post-transplant maintenance set...

The trials that we use to guide our practice for using daratumumab in newly diagnosed transplant eligible myeloma (PERSEUS and GRIFFIN prior to that), do not isolate the role of daratumumab in induction versus maintenance. A trial that isolated the role of any maintenance in the era of quads (CASSIO...

I think Dr. @Dr. First Last has summarized things well. One additional point I will make is that the Emory group presented on a very large series of patients treated with Dara-VRd and transplant, after which standard-risk patients received only lenalidomide and high-risk patients received a PI/IMiD....

Dr. @Dr. First Last has summarized the data well. The phrase "standard-risk cytogenetics" has not aged well, and I am hoping that more precise language will be more commonplace, incorporating the influence of increased LDH, 1q+, del 1p, circulating plasma cells, etc.

While Dara+Len is not yet as well...

The MSK SOC is based on MRD at 10⁻⁶. If patients achieve it post-transplant in standard risk, then Len maintenance. For MRD-positive post-ASCT and high-risk patients, dual-drug maintenance.

While lenalidomide remains the standard maintenance in the U.S., emerging evidence supports daratumumab maintenance as an effective alternative or addition; however, optimal sequencing and long-term outcomes (including overall survival) require further study. (Moreau et al., PMID 38889735) The benef...