Daratumamab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: final analysis of MAIA

The multinational phase 3 MAIA trial evaluated addition of daratumumab (D) to lenalidomide-dexamethasone (Rd) in transplant-ineligible newly diagnosed multiple myeloma (NDMM). In previous analyses of MAIA, D-Rd (n=368) significantly improved progression-free survival and overall survival versus Rd (n=369). Long-term overall survival and subsequent antimyeloma therapies from the MAIA final analysis have now been published. At a median follow-up of 89.3 months (IQR 85.3-93.0), median overall survival was 90.3 months with D-Rd versus 64.1 months with Rd (HR 0.67; 95% CI 0.55-0.82). Median time to subsequent antimyeloma treatment was not reached for D-Rd and was 42.4 months for Rd (HR 0.51; 95% CI 0.41-0.63). Death due to adverse events occurred in 12% of patients receiving D-Rd versus 11% of patients receiving Rd. The authors conclude that with more than 7 years of follow-up, D-Rd demonstrated a new benchmark for median overall survival in transplant-ineligible NDMM.