Efficacy and Safety of Daratumumab-Based Quadruplet Therapy Vs Non-Daratumumab-Based Triplet Therapy in Newly Diagnosed Multiple Myeloma Patients: A Systematic Review and Meta-Analysis
Abstract
Introduction: Multiple Myeloma (MM) involves the clonal proliferation of plasma cells and is the second most common hematologic malignancy, with a five-year Overall Survival (OS) rate of 48.5%. National Comprehensive Cancer Network (NCCN) guidelines v4.2024 recommend triple therapy regimens as preferred induction therapy in both Transplant-Eligible (TE) and Transplant-Ineligible (TIE) patients. However, quadruplet therapy regimens comprising a CD 38 monoclonal antibody like daratumumab have been introduced, leading to a higher Minimal Residual Disease (MRD) negativity and deeper responses, translating into longer Progression-Free Survival (PFS). This study compares the efficacy and safety of daratumumab-based quadruplet therapy regimens with standard triplet therapy regimens in NDMM patients.
Methods: We conducted a comprehensive electronic search of PubMed, Embase, Cochrane Database of Systemic Reviews, and clinicaltrial.gov up to July 1, 2024, using relevant MeSH terms and keywords for “Multiple Myeloma” and “Daratumumab”. Inclusion criteria encompassed randomized controlled trials (RCTs) comparing daratumumab-based quadruplet therapy versus non-daratumumab-based triplet therapy in NDMM patients. Primary efficacy outcomes focused on PFS and stringent complete response (sCR). Secondary outcomes included overall response rate (ORR), complete response (CR), complete response or better (≥CR), very good partial response rate (VGPR), very good partial response rate or better…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,048 participants or records.
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