A Matching-Adjusted Indirect Comparison (MAIC) of Daratumumab-Bortezomib-Thalidomide-Dexamethasone (D-VTd) Versus Bortezomib-Lenalidomide-Dexamethasone (VRd) in Patients (Pts) With Newly Diagnosed Multiple Myeloma (NDMM) who are Transplant Eligible

Moreau, Philippe; Attal, Michel; Façon, Thierry; Leleu, Xavier; Hulin, Cyrille; Hashim, Mahmoud; Hu, Yannan; Côté, Sarah; Kampfenkel, Tobias; Boer, Carla de; Lam, Annette; Sonneveld, Pieter

doi:10.1016/j.clml.2019.09.333

Cited by 6 publications

(6 citation statements)

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“…Moreover, a matching-adjusted indirect comparison (MAIC) demonstrated that dara-VTD (as in the CASSIOPEIA trial) was superior to VRD in transplant-eligible patients. This result confirms and underlines the efficacy of the addition of anti-CD38 mAb in comparison to conventional MM regimen (24).…”

Section: Daratumumabsupporting

confidence: 82%

The Role of Immunotherapy in Non-transplant Eligible Multiple Myeloma

et al. 2020

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As the global population is aging and survival in multiple myeloma (MM) is increasing, treating older MM patients, redefined as non-transplant eligible (NTE), is becoming more frequent. Yet, treating these patients remains a real challenge especially because of a marked heterogeneity in the population and an increased susceptibility to treatment toxicity. Indeed, the balance between efficacy and safety must be considered at all time throughout the treatment history for these patients. Therefore, younger and older patients were historically treated in a very different way, even though the safety profile of most anti-myeloma drugs has drastically improved over the years. The emergence of immunotherapy (IT) has largely widened the therapeutic options available in MM and above all has allowed a therapy at optimal dose, and therefore optimal activity, for all patients independently of their frailty features, with no increase in safety issues. Among the novel anti-myeloma IT-based agents, anti-CD38 monoclonal antibodies (mAbs) are now becoming the new backbone of treatment for NTE patients, in association with lenalidomide and dexamethasone. Moreover, several new IT-based drugs are currently being developed and investigated either alone or in association; such as new anti-CD38 mAbs, anti-CD38 mAbs with many different combinations, but also the CART cells, bispecific T-cell engager (BiTEs), or antibody drug conjugate (ADC) targeting BCMA. One would expect that immunotherapy will ultimately change and even transform the MM landscape, even for elderly patients. Immunotherapy represents a shift in treatment paradigm in MM as it provides truly efficient drugs with a very favorable safety profile.

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Section: Daratumumabsupporting

confidence: 82%

The Role of Immunotherapy in Non-transplant Eligible Multiple Myeloma

et al. 2020

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“…No randomized trials have directly compared D-VTd to VRD but a matching-adjusted indirect comparison (MAIC) of 543 patients receiving four courses of D-VTd plus ASCT vs 350 patients enrolled in the IFM2009 trial and treated with three cycles VRD plus ASCT, has been presented at the last International Myeloma Workshop ( 9 ). This MAIC showed that D-VTd plus ASCT significantly improves PFS and MRD negativity compared to VRD plus ASCT.…”

Section: Transplant-eligible Newly Diagnosed Multiple Myeloma Patientmentioning

confidence: 99%

Daratumumab for the Management of Newly Diagnosed and Relapsed/Refractory Multiple Myeloma: Current and Emerging Treatments

et al. 2021

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Immunotherapy is changing the paradigm of multiple myeloma (MM) management and daratumumab is the first-in-class human monoclonal antibody targeting CD38 approved for the treatment of this malignancy. Daratumumab exerts anti-myeloma activity by different mechanisms of action as antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cellular phagocytosis (ADCP), complement-dependent cytotoxicity (CDC), direct apoptosis, and immunomodulation. After GEN501 and SIRIUS trials showed efficacy of daratumumab monotherapy in heavily pretreated relapsed-refractory multiple myeloma (RRMM), in patients with at least two previous line of therapy, two phase III trials demonstrated superior overall response rate (ORR) and progression free survival (PFS) using triplets daratumumab–bortezomib–dexamethasone (DVd) vs Vd (CASTOR) or daratumumab–lenalidomide–dexamethasone (DRd) vs Rd (POLLUX) in relapsed-refractory MM patients; so these combinations have been approved and introduced in clinical practice. The ongoing phase III CANDOR is evaluating the triplet daratumumab–carfilzomib–dexamethasone (DKd) vs Kd whereas phase III APOLLO trial is exploring daratumumab–pomalidomide–dexamethasone (DPd) vs PD. Many other trials exploring daratumumab combinations in relapsed-refractory MM are ongoing, and they will provide other interesting results. In newly diagnosed transplant-eligible patients, phase III CASSIOPEIA trial found the combination daratumumab–bortezomib–thalidomide–dexamethasone (Dara-VTd) significantly improves stringent Complete Response (sCR) rate and PFS compared with VTD, whereas in the phase II GRIFFIN study, comparing daratumumab–bortezomib–lenalidomide–dexamethasone (Dara-VRD) vs VRD, sCR rate was significantly higher using quadruplet combination. Many studies are evaluating daratumumab in consolidation and maintenance therapy after autologous stem cell transplantation (ASCT). As regard patients ineligible for ASCT, a great efficacy of daratumumab-containing combinations was reported by the phase III trials ALCYONE and MAIA, exploring daratumumab–bortezomib–melphalan–prednisone (DVMP) vs VMP and daratumumab–lenalidomide–dexamethasone (DRd) vs Rd, respectively. These studies provided results never seen before in this setting. The aim of this paper is to critically review the results obtained with regimens containing daratumumab both in relapsed-refractory and in newly diagnosed MM.

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“…A Google search including all hits has returned 40 unique manuscripts and conference proceedings that were published between 2011 -February 2022 (excluding the three MAICs conducted and published for the purpose of this thesis), with half of them being published from 2020 onwards [71,73,. Of these, three were anchored MAICs [71,75,80], 16 were unanchored MAICs [78,79,84,85,90,91,[94][95][96][97]102,[107][108][109][110]112], and for 21 anchoring was not specified [73,76,77,[81][82][83][86][87][88][89]92,93,[98][99][100][101][103][104][105][106]111].…”

Section: Targeted Literature Review Of Maics Conducted In Practicementioning

confidence: 99%

“…Most of the published MAICs were in relapsed/refractory [105][106][107][108][109][110][111][112] multiple myeloma [84][85][86][87][88][89][90][91], followed by chronic myeloid leukaemia [73,[80][81][82][83], relapsed/refractory diffuse large Bcell lymphoma [93][94][95][96][97][98], and relapsed/refractory follicular lymphoma [99][100][101][102]. The fewest MAICs were published in relapsed/refractory acute lymphoblastic leukaemia [71], and relapsed/refractory classical Hodgkin lymphoma [92], with one publication for each.…”

Section: Targeted Literature Review Of Maics Conducted In Practicementioning

confidence: 99%

“…A clear differentiation between effect modifiers and prognostic factors was made in only three publications [97,102,106] of the 16 MAICs explicitly identified as "unanchored". Effect modifiers/prognostic factors have been listed without a justification of their source in 14 cases [73,75,80,82,84,87,88,91,93,94,100,103,106,111]. Expert/clinician opinion was obtained in seven cases [78,95,97,101,102,104,105].…”

Section: Targeted Literature Review Of Maics Conducted In Practicementioning

confidence: 99%

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Matching-Adjusted Indirect Comparisons Applied for Comparative Efficacy of Haematologic Cancer Drugs within Health Economic Analysis

Muresan¹

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Matching-adjusted indirect comparisons (MAICs) have been used in health technology assessment submissions for a decade now. In theory, their specific utility could diminish the need for randomized-controlled trials (RCTs) and hence reduce the financial burden on manufacturers, as well as speed up patient access to novel drugs. However, despite the clarity in guidelines on methodological aspects, more research was needed and more time was required to fully understand their applicability in practice, their impact on health economic models, and the outlook of reimbursement agencies on them. Hence, the justification for the current thesis comes for it being researched and conducted during the "prime years" of MAICs.

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A Matching-Adjusted Indirect Comparison (MAIC) of Daratumumab-Bortezomib-Thalidomide-Dexamethasone (D-VTd) Versus Bortezomib-Lenalidomide-Dexamethasone (VRd) in Patients (Pts) With Newly Diagnosed Multiple Myeloma (NDMM) who are Transplant Eligible

Cited by 6 publications

References 0 publications

The Role of Immunotherapy in Non-transplant Eligible Multiple Myeloma

The Role of Immunotherapy in Non-transplant Eligible Multiple Myeloma

Daratumumab for the Management of Newly Diagnosed and Relapsed/Refractory Multiple Myeloma: Current and Emerging Treatments

Matching-Adjusted Indirect Comparisons Applied for Comparative Efficacy of Haematologic Cancer Drugs within Health Economic Analysis

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