On January 13, 2020 John Theurer Cancer Center at Hackensack University Medical Center in New Jersey were part of the CANDOR global phase III clinical trial for patients with refractory (persistent) multiple myeloma (Press release, John Theurer Cancer Center, JAN 13, 2020, View Source [SID1234553124]). The study was selected as the prestigious plenary presentation at the 61st American Society of Hematology (ASH) (Free ASH Whitepaper) Annual Meeting, the world’s leading conference for hematologic cancers and blood disorders, held in Orlando in December.
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The CANDOR study showed that the addition of the anti-CD38 monoclonal antibody daratumumab to treatment with carfilzomib and dexamethasone was more effective than conventional carfilzomib and dexamethasone. Patients receiving the three-drug regimen experienced a 37% reduction in the risk of disease progression or death, establishing a new standard of care. Patients in the CANDOR trial had been heavily pretreated and most had failed to respond to lenalidomide, an immunomodulating drug that forms the backbone of most multiple myeloma treatment regimens.
"In this population, we have had limited choices. This study shows that we can safely combine what are arguably the most active drugs for the treatment of myeloma," explained David Siegel, M.D., Ph.D., founding director of John Theurer Cancer Center’s Multiple Myeloma Institute, who led John Theurer Cancer Center’s involvement in the study. "Treatment with daratumumab, carfilzomib, and dexamethasone represents a new effective regimen for patients with recurrent or persistent multiple myeloma, especially those whose disease came back or continues to grow after lenalidomide therapy."
The phase III CANDOR study included 466 patients with multiple myeloma that persisted despite one to three prior regimens of therapy. Patients were randomly assigned 2:1 to receive either daratumumab, carfilzomib, and dexamethasone or carfilzomib and dexamethasone. After a median follow-up of 17 months, the median progression-free survival was not yet reached in the three-drug combination group, versus 16 months in patients receiving the standard therapy. Patients receiving three drugs had a better overall response rate (84.3% versus 74.7%) and a better rate of complete response or better (28.5% versus 10.4%), and the achievement of undetectable disease was nearly ten times higher (12.5% versus 1.3%). It was too early to detect any differences in overall survival.