Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis

Abstract In previous analyses of MAIA, daratumumab plus lenalidomide/dexamethasone (D-Rd) significantly improved progression-free survival and overall survival (OS) versus lenalidomide/dexamethasone (Rd) in transplant-ineligible newly diagnosed multiple myeloma (NDMM). We report results on long-term OS and subsequent antimyeloma therapies from the MAIA final analysis. A protocol amendment (July 20, 2021) led to a long-term extension of MAIA, during which patients were followed for OS. A total of 737 patients were randomized to D-Rd ( n = 368) or Rd ( n = 369). At a median follow-up of 89.3 months (range, 0.0–102.2; interquartile range, 85.3–93.0), median OS was 90.3 months (95% confidence interval [CI], 80.8–not estimable [NE]) with D-Rd versus 64.1 months (56.0–70.8) with Rd (hazard ratio [HR], 0.67; 95% CI, 0.55–0.82); estimated 7-year OS rates were 53.1% (95% CI, 47.8–58.2) and 39.3% (34.1–44.5), respectively. Median time to subsequent antimyeloma treatment was not reached (95% CI, 84.1–NE) for D-Rd versus 42.4 months (33.5–50.6) for Rd (HR, 0.51; 95% CI, 0.41–0.63; P < 0.0001). Death due to adverse events occurred in 84 patients (D-Rd, n = 44/364 [12%]; Rd, n = 40/365 [11%]). With >7 years of follow-up, D-Rd demonstrated a new benchmark for median OS (7.5 years) in transplant-ineligible NDMM, further supporting frontline D-Rd use to maximize survival.

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Publication Details

Journal
Leukemia
Published
2026-08-24
DOI
https://doi.org/10.1038/s41375-026-03097-9
Primary Topic
Multiple Myeloma Research and Treatments
Type
article
Field-Weighted Citation Impact
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article

Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis

Ajai Chari, Saad Z. Usmani, Mohamad Mohty, Katja Christina Weisel et al.
Leukemia
Multiple Myeloma Research and Treatments
article

Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis

Ajai Chari, Saad Z. Usmani, Mohamad Mohty, Katja Christina Weisel, Thierry T.F. Facon, Shaji Kunnathu Kumar, Torben Plesner, Salomon Manier, Robert Zygmunt Orlowski, Gordon C Cook, Huiling Pei, Caroline Jacquet, Xavier P Leleu, Fredrik Borgsten, Noopur S Raje, Hartmut Goldschmidt, Nizar Jacques Bahlis, Margaret Macro, Markus Hansson, Aurore Perrot, Sonja Zweegman, Supratik Basu, Cyrille Hulin, Hang Quach, Laurent Frenzel, Michel Delforge, Philippe Moreau, Mourad Tiab, Kasey Bolyard, Christopher P. Venner, George Wang, Robin Carson
article en

Abstract

Abstract In previous analyses of MAIA, daratumumab plus lenalidomide/dexamethasone (D-Rd) significantly improved progression-free survival and overall survival (OS) versus lenalidomide/dexamethasone (Rd) in transplant-ineligible newly diagnosed multiple myeloma (NDMM). We report results on long-term OS and subsequent antimyeloma therapies from the MAIA final analysis. A protocol amendment (July 20, 2021) led to a long-term extension of MAIA, during which patients were followed for OS. A total of 737 patients were randomized to D-Rd ( n = 368) or Rd ( n = 369). At a median follow-up of 89.3 months (range, 0.0–102.2; interquartile range, 85.3–93.0), median OS was 90.3 months (95% confidence interval [CI], 80.8–not estimable [NE]) with D-Rd versus 64.1 months (56.0–70.8) with Rd (hazard ratio [HR], 0.67; 95% CI, 0.55–0.82); estimated 7-year OS rates were 53.1% (95% CI, 47.8–58.2) and 39.3% (34.1–44.5), respectively. Median time to subsequent antimyeloma treatment was not reached (95% CI, 84.1–NE) for D-Rd versus 42.4 months (33.5–50.6) for Rd (HR, 0.51; 95% CI, 0.41–0.63; P < 0.0001). Death due to adverse events occurred in 84 patients (D-Rd, n = 44/364 [12%]; Rd, n = 40/365 [11%]). With >7 years of follow-up, D-Rd demonstrated a new benchmark for median OS (7.5 years) in transplant-ineligible NDMM, further supporting frontline D-Rd use to maximize survival.

Leukemia
University of Wolverhampton (GB), Hôpital Necker-Enfants Malades (FR), BC Cancer Agency (CA), University of Leeds (GB), Johnson & Johnson (United States) (US), Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), University of Alberta (CA), Universität Hamburg (DE), The University of Melbourne (AU), University of Calgary (CA), University of Southern Denmark (DK), Heidelberg University (DE), Université de Lille (FR), Sahlgrenska University Hospital (SE), University Hospital Heidelberg (DE), WinnMed (US), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Toulouse (FR), Leeds Trinity University (GB), Sorbonne Université (FR), St Vincent's Hospital Melbourne (AU), Massachusetts General Hospital (US), Institute of Cancer Research (CA), Vejle Sygehus (DK), Institut universitaire du cancer de Toulouse Oncopole (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Roche (France) (FR), University Medical Center Hamburg-Eppendorf (DE), Centre Hospitalier Universitaire de Poitiers (FR), National Center for Tumor Diseases (DE), Centre Hospitalier Universitaire de Caen Normandie (FR), Hôpital Cardiologique du Haut-Lévêque (FR), Centre de Recherche Saint-Antoine (FR), Centre Hospitalier Départemental Vendée (FR), The Royal Wolverhampton NHS Trust (GB), Hôpital Claude Huriez (FR), Vrije Universiteit Amsterdam (NL), Nantes Université (FR), Université de Caen Normandie (FR), Icahn School of Medicine at Mount Sinai (US)
Good health and well-being
Openalex Percentile: Top 10%
Multiple Myeloma Research and Treatments
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