Prescribing carfilzomib- or pomalidomide-based therapeutic regimens does not appear to benefit patients with relapsed multiple myeloma (MM) following daratumumab-based treatment, according to research published in the European Journal of Haematology.

Anti-CD38 monoclonal antibodies such as daratumumab have improved progression-free (PFS) and overall survival (OS) rates in this patient population, but relapse or refractory disease remain common.

Large numbers of patients are treated with at least 3 therapeutic types, which is known as triple-class exposure. However, whether patients treated with multiple drug classes, including daratumumab, have improved outcomes after receiving carfilzomib- or pomalidomide-based regimens was previously unknown.

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For this study, researchers evaluated real-world data to determine PFS and OS rates among patients with relapsed or refractory MM treated with daratumumab.

Overall, data from 178 patients were included, among whom 75 had received a carfilzomib-based therapy, 79 had received a pomalidomide-based therapy, and 24 had received an immunomodulatory drug plus a proteasome inhibitor based on carfilzomib or pomalidomide.

In the overall cohort, the median age at diagnosis was 61.5 years, 55.1% of patients were male, the median number of prior therapy lines was 3, and 97.2% of patients were triple-class exposed (59.6% were triple-class refractory).

Analysis showed that, among all included patients, the median PFS and OS periods were 4.5 and 14.2 months, respectively. Patients who received carfilzomib had median PFS and OS periods of 4.5 and 10.2 months, respectively; these rates were, however, longer among patients who received pomalidomide (5.2 and 21.7 months).

Patients who received an immunomodulatory drug and proteasome inhibitor had median PFS and OS periods of 4.1 and 14.5 months, respectively.

“Our results confirm that novel therapies, including immune therapies, are urgently needed to improve outcomes among these patients,” the authors wrote in their report. “Our results also provide a benchmark for comparison of the outcome of myeloma with promising novel immune therapies.”

Disclosures: This research was supported by Janssen. Please see the original reference for a full list of disclosures.


LeBlanc R, Mian H, Reece D, et al. Outcome of carfilzomib/pomalidomide-based regimens after daratumumab-based treatment in relapsed multiple myeloma: A Canadian Myeloma Research Group Database analysis. Eur J Haematol. Published online August 13, 2023. doi:10.1111/ejh.14082