Modeling Projects Longer PFS With DVRd in Newly Diagnosed Multiple Myeloma

In newly diagnosed multiple myeloma (NDMM), daratumumab, bortezomib, lenalidomide, and dexamethasone (DVRd) significantly improved progression-free survival (PFS) compared with VRd in both transplant-eligible (TE; PERSEUS trial) and transplant-ineligible (TIE; CEPHEUS trial) cohorts. Because median PFS had not been reached with DVRd in either trial, investigators extrapolated trial data using seven parametric distributions in accordance with UK National Institute for Health and Care Excellence (NICE) guidance to project long-term survival outcomes.

In the transplant-eligible PERSEUS population, projected median PFS ranged from 158 to 255 months with DVRd compared to 76 to 119 months with VRd across all distributions. The best-fit model (exponential distribution) estimated a median PFS of 205 months (17.1 years; range, 13.2–21.2) for DVRd compared with 87 months (7.3 years; range, 6.3–9.9) for VRd. In the transplant-ineligible CEPHEUS population, the projected median PFS range across distributions was 96 to 118 months for DVRd versus 52 to 54 months for VRd, with best-fit estimates reaching 100 months (8.3 years; range, 8.0–9.8) for DVRd compared to 53 months (4.4 years; range, 4.3–4.5) for VRd. Across all seven fitted distributions, PFS projections were significantly longer with DVRd than VRd, supporting DVRd as a standard-of-care regimen in NDMM irrespective of transplant eligibility.