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Clinical evaluation of daratumumab in combination with lenalidomide and bortezomib and with daratumumab， bortezomib， and dexamethasone for the treatment of relapsed and refractory multiple myeloma
Received date: 2025-07-02
Online published: 2025-09-25
Objective To evaluate the clinical efficacy and safety of the daratumumab-based regimens， including daratumumab， dexamethasone， and lenalidomide （DRd）， as well as daratumumab， dexamethasone， and bortezomib （DVd）， in the treatment of patients with relapsed or refractory multiple myeloma （RRMM） at our center. Methods Eighty patients with RRMM were assigned to either the DRd group （42 cases） or the DVd group （38 cases） based on their treatment regimens. Both groups received a baseline treatment of daratumumab combined with dexamethasone （Dd regimen）. In the DVd group， 1.3 mg/m2 of bortezomib was administered subcutaneously on days 1， 4， 8， and 11 of each cycle， followed by a 10 day drug-free interval （days 12 ~ 21）， repeated every 3 weeks until disease progression. In the DRd group， 25 mg of lenalidomide was orally administered daily from day 1 to day 21 of each cycle， in addition to the Dd regimen， continuing until disease progression. The two groups were compared in terms of laboratory parameters， tumor markers， clinical efficacy， safety profiles， and long-term prognostic outcomes. Results After treatment， the overall response rate （ORR） of the DRd group and the DVd group was 78.57% （33 out of 42 cases） and 52.63% （20 out of 38 cases）， respectively. The serum creatinine （SCr） levels were （92.54 ± 14.33） and （102.07 ± 15.41） μmol/L， respectively； the M protein contents were （19.62 ± 2.04） and （21.08 ± 2.23） g/L， respectively； the β2-microglobulin （β2-MG） levels were （3.49 ± 1.12） and （4.16 ± 1.25） mg/L， respectively； and the progression-free survival rates were 42.86% （18 out of 42 cases） and 26.32% （10 out of 38 cases）， respectively. All these indicators showed statistically significant differences between the DRd group and the DVd group （all P < 0.05）. The incidence rates of adverse reactions in the observation group and the control group were 14.29% （6 out of 42 cases） and 13.16% （5 out of 38 cases）， respectively， and the difference was not statistically significant （P > 0.05）. Conclusion The DRd regimen demonstrates superior efficacy compared to the DVd regimen in treating patients with RRMM， leading to improved patient prognosis with a favorable safety profile.
Yuchen ZHAO , Manting XU , Jing BAO , Liang XIA . Clinical evaluation of daratumumab in combination with lenalidomide and bortezomib and with daratumumab， bortezomib， and dexamethasone for the treatment of relapsed and refractory multiple myeloma[J]. The Journal of Practical Medicine, 2025 , 41(18) : 2913 -2919 . DOI: 10.3969/j.issn.1006-5725.2025.18.019
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