Advances in myeloma treatment have significantly improved patient outcomes, with the combination of lenalidomide, bortezomib, and dexamethasone (RVd) becoming a cornerstone of care. Retrospective analyses, including a study of 1,000 newly diagnosed patients with multiple myeloma (NDMM), demonstrated impressive median progression-free survival (PFS) of 68.7 months and median overall survival of nearly 11 years with RVd therapy followed by autologous stem cell transplantation and maintenance treatment. Building on these results, the addition of daratumumab (Dara-RVd) has shown further promise. Phase 2 and 3 trials, such as GRIFFIN and PERSEUS, highlighted superior PFS rates and higher minimal residual disease negativity with the quadruplet regimen, positioning Dara-RVd as a potential new standard of care.

Real-world data from a cohort of 326 patients with NDMM treated with Dara-RVd confirms its efficacy, with a 2-year PFS of 93% compared to 82% for RVd. The quadruplet induction demonstrated benefits across both standard- and high-risk groups, including higher response rates and deeper remissions. This analysis aligns with randomized trial findings and underscores Dara-RVd’s effectiveness in clinical practice. 

Reference: Joseph NS, Kaufman JL, Gupta VA, et al. Quadruplet therapy for newly diagnosed myeloma: comparative analysis of sequential cohorts with triplet therapy lenalidomide, bortezomib and dexamethasone (RVd) versus daratumamab with RVD (DRVd) in transplant-eligible patients. Blood Cancer J. 2024;14(1):159. doi: 10.1038/s41408-024-01120-9.