Dr. Shaji Kumar from Mayo Clinic presents the results of the ASCENT trial, which studied fixed-duration therapy with Daratumumab, Carfilzomib, and Dexamethasone for high-risk smoldering multiple myeloma.

Background:

The optimal approach for high-risk Smoldering Multiple Myeloma patients is still being investigated. Two phase 3 trials have shown that treatment with lenalidomide with or without dexamethasone reduces the risk of progression to active MM and improved overall survival compared to observation alone. Intense therapy at this precursor phase can potentially eradicate the malignant clone and lead to long-term remissions or a cure. The ASCENT trial is designed to test this hypothesis.

Conclusions:

The combination of daratumumab, carfilzomib, lenalidomide and dexamethasone given for a fixed duration of 2 years was associated with high response rates and deep responses including high rates of MRD negativity. The regimen was well tolerated, with few grade 3 or 4 toxicity. The responses appear durable as indicated by the sustained MRD negativity as well as the 3-year PFS rate of 90%. With nearly half of the patients still receiving therapy, the depth of response is expected to improve.

Authors:

Shaji K Kumar, MD, Melissa Alsina, MD, Betsy Laplant, MS, Ashraf Z. Badros, MD, Al-Ola Abdallah, MD, Rafat Abonour, MD, Erik J Asmus, Binod Dhakal, MBBS, Cara A. Rosenbaum, MD, Daniel Egan, MD, Manisha Bhutani, MD, Andrzej Jakubowiak, MD, PhD and Brian G.M. Durie, MD

ASH Abstract #757: https://ash.confex.com/ash/2022/webprogram/Paper168930.html (https://ash.confex.com/ash/2022/webprogram/Paper168930.html)