MAIA frailty subgroup analysis: long-term follow-up with daratumumab plus lenalidomide/dexamethasone in transplant-ineligible newly diagnosed myeloma
Abstract In MAIA (Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma), daratumumab plus lenalidomide/dexamethasone (D-Rd) improved progression-free survival (PFS) and overall survival (OS) versus Rd in transplant-ineligible newly diagnosed multiple myeloma (NDMM). Here, we report an updated subgroup analysis by frailty status. We retrospectively performed frailty assessments using age, Charlson Comorbidity Index, and baseline Eastern Cooperative Oncology Group performance status score; patients were classified as fit, intermediate, non-frail (fit + intermediate), or frail. After a 64.5-month median follow-up, OS benefit of D-Rd versus Rd was maintained in the non-frail subgroup (median, not reached [NR] vs 69.8 months; hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.37–0.76; P = 0.0004); the OS HR point estimate favored D-Rd versus Rd in the frail subgroup (NR vs 50.4 months; HR, 0.79; 95% CI, 0.58–1.06; P = 0.1128). Improved PFS and rates of complete response or better and minimal residual disease negativity (10 –5 ) were observed with D-Rd versus Rd across frailty subgroups. Duration of therapy was consistently longer with D-Rd versus Rd, highlighting the improved disease control and long-term tolerability of daratumumab in frail patients. These long-term data, although limited by the retrospective assessment of frailty using baseline characteristics, continue to support the therapeutic benefit of D-Rd in terms of improved PFS and higher rates of deep responses in transplant-ineligible NDMM, regardless of frailty status.
Authors
- Saad Z. Usmani (ORCID: https://orcid.org/0000-0002-5484-8731)
- Mohamad Mohty (ORCID: https://orcid.org/0000-0002-7264-808X)
- Katja Christina Weisel (ORCID: https://orcid.org/0000-0001-9422-6614)
- R Carson
- Salomon Manier (ORCID: https://orcid.org/0000-0001-7653-711X)
- Gordon C Cook (ORCID: https://orcid.org/0000-0003-1717-0412)
- Fredrik Borgsten
- Hartmut Goldschmidt (ORCID: https://orcid.org/0000-0003-0961-0035)
- Cyrille Touzeau (ORCID: https://orcid.org/0000-0003-0275-2575)
- Nizar Jacques Bahlis (ORCID: https://orcid.org/0000-0001-7353-7034)
- Sonja Zweegman (ORCID: https://orcid.org/0000-0002-5011-1820)
- Supratik Basu (ORCID: https://orcid.org/0000-0003-2206-4796)
- Cyrille Hulin (ORCID: https://orcid.org/0000-0002-3749-5161)
- Hang Quach (ORCID: https://orcid.org/0000-0002-4796-3352)
- Mai Ngo
- Kasey Bolyard
- Marjohn Armoon
- Christopher P. Venner
- Noopur Raje
- Thierry Facon
- Shaji Kumar
Institutions
- University of Wolverhampton (GB)
- BC Cancer Agency (CA)
- University of Leeds (GB)
- Johnson & Johnson (United States) (US)
- Mayo Clinic (US)
- Memorial Sloan Kettering Cancer Center (US)
- University of Alberta (CA)
- The University of Melbourne (AU)
- University of Calgary (CA)
- Heidelberg University (DE)
- Université de Lille (FR)
- University Hospital Heidelberg (DE)
- Centre Hospitalier Universitaire de Lille (FR)
- Centre Hospitalier Universitaire de Nantes (FR)
- Sorbonne Université (FR)
- St Vincent's Hospital Melbourne (AU)
- Massachusetts General Hospital (US)
- Hôpital Saint-Antoine (FR)
- University Medical Center Hamburg-Eppendorf (DE)
- Hôpital Cardiologique du Haut-Lévêque (FR)
- Cancer Research UK Clinical Trials Unit (GB)
- Amsterdam University Medical Centers (NL)
- The Royal Wolverhampton NHS Trust (GB)
- Hôpital Claude Huriez (FR)
- Cancer Center Amsterdam (NL)
- Cross Cancer Institute (CA)
- Vrije Universiteit Amsterdam (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Cytel (United States) (US)
- Nantes Université (FR)
Publication Details
- Journal
- Leukemia
- Published
- 2026-10-06
- DOI
- https://doi.org/10.1038/s41375-026-03128-5
- Primary Topic
- Multiple Myeloma Research and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00