CASSIOPEIA
CASSIOPEIA showed that adding the CD38 antibody daratumumab to a three-drug induction before stem cell transplant put more people with myeloma into deep remission and kept the disease away for longer.
Overview
CASSIOPEIA, run by the French and Dutch myeloma groups with Janssen, randomised 1085 transplant-eligible patients with newly diagnosed multiple myeloma to VTd (bortezomib, thalidomide, dexamethasone) induction and post-transplant consolidation with or without daratumumab (part 1), then re-randomised responders to daratumumab maintenance or observation (part 2). The part 1 primary endpoint was the stringent complete response rate after consolidation.
Daratumumab-VTd increased stringent complete responses and minimal residual disease negativity and lengthened progression-free survival, leading to European and United States approval of the quadruplet in 2019 and 2020, the first daratumumab approval in the transplant setting. Part 2 showed that daratumumab maintenance lengthened progression-free survival mainly in patients who had not received it during induction.
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