“We are quite optimistic that a number of these patients will indeed have sustained MRD-negative status and may end up indeed being cured by this early aggressive intervention.” — Dr. Brian G.M. Durie
The BOTTOM LINE: Longer term follow up is needed. We are optimistic that a number of these patients will have sustained MRD-negative status and potentially be cured by this early and aggressive intervention.
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This week's "Ask Dr. Durie" comes from a patient who wants to know what the results of the ASCENT trial are. Very good question. And for those who are not familiar, the ASCENT trial is a treatment regimen being evaluated in patients with high-risk smoldering myeloma.
The treatment being evaluated is a combination of daratumumab, carfilzomib, Revlimid, and dexamethasone. And so is this the Dara-KRd regimen.
The results were presented at the ASH meeting in December 2022 by Dr. Shaji Kumar from the Mayo Clinic, who leads this Black Swan Research Initiative protocol. The results have been remarkably good. 97% of the patients had an overall response in this treatment protocol and 84% had MRD-negative status achieved.
So, 84% of the patients had a very, very deep response to the regimen. The treatment has been well-tolerated with no new toxicity signals different than what has been observed using this combination in other disease settings—and so, quite promising.
At this point, the majority of patients are being followed after two years of treatment off all therapy. And so, this is a very attractive part of the protocol for the patients who have achieved deep responses and are now being followed off of all therapy.
And so, the BOTTOM LINE right now, between three or four years of follow-up, we need to continue the follow-up out beyond five years and see what the sustained remission will be. What will be the sustained MRD-negativity that is achieved?
And we are quite optimistic that a number of these patients will indeed have sustained MRD-negative status and may end up indeed being cured by this early aggressive intervention. So very, very promising results.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF.
