KdD outperforms Kd in R/R MM also in participants with poor renal function

A regimen of carfilzomib, daratumumab, and dexamethasone (KdD) improved survival outcomes compared with a regimen of carfilzomib and dexamethasone (Kd) in participants with relapsed/refractory (R/R) multiple myeloma (MM), regardless of baseline renal function, as shown by a subgroup analysis of the phase 3 CANDOR trial.

Poor renal functioning is a common complication in patients with MM and has been linked to inferior survival outcomes [1]. The phase 3, open-label CANDOR trial (NCT03158688) randomised participants with R/R MM 2:1 to KdD (n=312) or Kd (n=154) [2]. Prof. Meletios Dimopoulos (University of Athens, Greece) presented the findings of a subgroup analysis comparing the efficacy and safety of these 2 regimens by baseline renal functioning [3].

KdD outperformed Kd and prolonged progression-free survival (PFS), irrespective of baseline renal status. In the group with creatine clearance (CrCL) of 15–60 mL/min, the median PFS was 24.9 months in the KdD group and 8.4 months in the Kd group (HR 0.61; 95% CI 0.35–1.06). The median PFS was 31.6 months in the CrCL of 60–90 mL/min group for KdD receiving participants and 19.9 months for Kd controls (HR 0.63; 95% CI 0.41–0.96). Finally, in the CrCl ≥90 mL/min group the median PFS was 27.4 vs 15.3 months, in favour of the KdD group (HR 0.64; 95% CI 0.43–0.95). The overall survival data displayed a trend towards a benefit for participants receiving KdD over Kd controls in all renal subgroups, especially in the subgroup of participants with CrCl of 15–60 mL/min (HR 0.58; 95% CI 0.32–1.03). Lastly, the safety findings were consistent with the overall study population.

Overall, KdD showed a consistent clinical benefit compared with Kd in median PFS, overall response rate, and overall survival irrespective of the baseline renal function.

1. Dimopoulos M, et al. J Clin Oncol. 2016;34(13):1544-1557.
2. Usmani SZ, et al. Blood Adv. 2023;7(14):3739-3748.
3. Dimopoulos M, et a. Carfilzomid, daratumumab, and dexamethasone (KdD) vs carfilzomib and dexamethasone (Kd) for relapsed/refractory multiple myeloma (R/R MM) in the phase 3 CANDOR study: subgroup analysis according to renal functioning. Poster 2021, 65^th ASH Annual Meeting, 9–12 December 2023, San Diego, CA, USA.

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Posted on 7 February 202428 March 2024