Indirect Comparison Indicates More Favorable OS for Multiple Myeloma Therapy


Daratumumab monotherapy produced better overall survival (OS) outcomes when compared with pomalidomide and low-dose dexamethasone in patients with heavily pretreated multiple myeloma, according to research published in The Oncologist (online November 30, 2017; doi:10.1634/theoncologist.2017-0103).

Daratumumab, a monoclonal antibody, and pomalidomide, an immunomodulatory drug, are both new therapies for the treatment of multiple myeloma. Suzy Van Sanden, PhD, Janssen Health Economics (Beerse, Belgium), and colleagues conducted a matching adjusted indirect comparison to determine how each treatment regimen influenced OS in myeloma patients.

Researchers used data from patients enrolled in the GEN501 and SIRIUS trials, where patients received 16 mg/kg daratumumab monotherapy; and the MM-003 and STRATUS trials, where patients received pomalidomide and low-dose (40 mg) dexamethasone.

The adjusted hazard ratio (HR) significantly favored daratumumab when compared with patients from the MM-003 (HR, 0.56; P = .0041) and STRATUS (HR, 0.51; P < .0001) trials. The benefit increased when the researchers restricted their analysis to pomalidomide-naive patients (MM-003 = HR, 0.33; STRATUS = HR, 0.41).


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This matching adjusted indirect comparison of clinical trial data from four studies analyzes the survival outcomes of patients with heavily pretreated, relapsed/refractory multiple myeloma who received either daratumumab monotherapy or pomalidomide plus lowdose dexamethasone,” researchers concluded. “Using this method, daratumumab conferred a significant OS  benefit compared with pomalidomide plus lowdose dexamethasone. In the absence of headtohead trials, these indirect comparisons provide useful insights to clinicians and reimbursement authorities around the relative efficacy of treatments.”Cameron Kelsall