The CEPHEUS trial results, presented at the 21st annual International Myeloma Society conference, advocate for the use of daratumumab plus VRd (bortezomib, lenalidomide, dexamethasone) as a new standard of care for transplant-ineligible patients with newly diagnosed multiple myeloma. The study suggests that quadruplet regimens could lead to deeper responses and improved progression-free survival in this patient population.
Building on Previous Success
The CEPHEUS trial builds upon the positive results observed in the MAIA trial, which established a new benchmark for treating transplant-ineligible patients with a median overall survival of 7.5 years using daratumumab along with lenalidomide and dexamethasone. According to Saad Z. Usmani, MD, MBA, FACP, a myeloma specialist at Memorial Sloan Kettering Cancer Center, the CEPHEUS trial explores a quadruplet regimen for patients who are relatively younger or more fit than the MAIA patient population, enabling them to undergo a four-drug induction therapy followed by a two-drug maintenance treatment.
Comparing CEPHEUS to MAIA
Dr. Usmani noted that the depth of response and progression-free survival benefit observed in the CEPHEUS trial appear to surpass those seen in the MAIA trial. This suggests that quadruplet induction regimens could be beneficial for a significant number of transplant-ineligible or deferred patients. The VRd combination was chosen as the standard-of-care arm based on the SWOG S0777 trial, which established VRd as a standard treatment for myeloma patients. Daratumumab has been combined with VRd in other clinical trials, including the GRIFFIN and PERSEUS studies.
Implications for Clinical Practice
The CEPHEUS trial's findings support the integration of anti-CD38 monoclonal antibody-based quadruplets into standard clinical practice for transplant-ineligible patients. By achieving deeper responses, this approach has the potential to improve long-term outcomes and quality of life for individuals newly diagnosed with multiple myeloma.
