Abstract

The CASTOR and POLLUX trials reported impressive rates of progression-free survival for the three-drug regimens of daratumumab with bortezomib and dexamethasone and daratumumab with lenalidomide and dexamethasone, respectively. At ASH 2016 Avet-Loiseau, et al, reported on rates of MRD negativity with these two three-drug combinations (Abstract 246). MRD was assessed by next generation sequencing of the VDJ region of the IGH locus. Three sensitivity thresholds were evaluated: 10-4, 10-5, and 10-6. Using the 10-6 threshold, 11.9 percent of patients receiving daratumumab with lenalidomide and dexamethasone and 4.4 percent of patients receiving daratumumab with bortezomib and dexamethasone were MRD negative compared with 2.5 percent and 0.8 percent rates for the Revlimid/dexamethasone and bortezomib/dexamethasone arms.