Efficacy and Safety of Daratumumab, Lenalidomide and Dexamethasone Therapy in the First Relapse of Multiple Myeloma Patients – Real World Data from Hungary
Bibliographic record
Abstract
Background: Daratumumab is a monoclonal antibody targeting CD38, which has demonstrated efficacy in both newly diagnosed and relapsed or refractory multiple myeloma (MM). The objective of our study was to evaluate the effectiveness and safety of the daratumumab, lenalidomide, and dexamethasone (D-Rd) regimen as a second-line therapy in a real-world clinical setting. Methods: A total of 55 Hungarian patients with MM were enrolled, all of whom received D-Rd at first relapse through a special reimbursement program between February 2022 and August 2023. Treatment responses, progression-free survival (PFS), and overall survival (OS) were assessed in the intent-to-treat population as well as in selected subgroups. Safety outcomes were also systematically collected. Results: Treatment response was observed in 49 patients (89%), with 12 complete responses, 22 very good partial responses, and 15 partial responses. After a median follow-up of 36.6 months, the median PFS for the entire cohort was 22.0 months, while median OS had not been reached yet. Patients with advanced-stage disease (Revised International Staging System stage 3) showed significantly poorer survival outcomes compared with those in stage 1 or 2 (PFS: P < 0.001; OS: P = 0.015). High-risk cytogenetic abnormalities and frailty were also associated with markedly inferior prognosis. In contrast, neither prior autologous stem cell transplantation nor lenalidomide maintenance therapy had a significant impact on survival. During the study period, three deaths due to severe infections occurred, while the most common adverse events were mild hematologic toxicities and injection-related reactions. Conclusions: Our findings support the use of D-Rd as an effective option for first relapse in MM patients. However, our survival data are inferior to the results of the pivotal studies targeting the same population.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".