Real-world comparison of remission status in newly diagnosed multiple myeloma treated with daratumumab-based versus bortezomib-based first-line therapy.

Abstract

e19572 Background: The introduction of CD38 monoclonal antibodies has transformed the frontline management of newly diagnosed multiple myeloma (NDMM). However, real-world differences in remission status between daratumumab-based and proteasome inhibitor–based first-line regimens remain incompletely characterized outside of clinical trials. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Adult patients (≥18 years) with NDMM were identified using ICD-10-CM codes and stratified by first-line treatment exposure to either daratumumab-based or bortezomib-based regimens. Patients receiving both agents were excluded to maintain mutually exclusive cohorts. Baseline demographics and disease remission status were assessed using diagnosis-level data available within the basic TriNetX platform. Results are reported descriptively Results: A total of 21,820 patients receiving first-line bortezomib-based therapy and 19,600 patients receiving first-line daratumumab-based therapy were identified across 123 and 109 healthcare organizations, respectively. Patients treated with daratumumab were slightly younger (mean age 71 vs 73 years), with similar sex distribution between cohorts. Remission status differed between treatment groups. Among patients receiving daratumumab, 46% were documented as being in remission compared with 33% in the bortezomib cohort. Conversely, a higher proportion of patients in the bortezomib group were classified as not having achieved remission (81% vs 87%) and fewer patients were documented as having relapsed disease in the bortezomib cohort (18% vs 33%). Conclusions: In this large real-world analysis of patients with NDMM, first-line daratumumab-based therapy was associated with a higher prevalence of documented remission compared with bortezomib-based therapy. These findings highlight meaningful differences in disease status between frontline treatment strategies in routine clinical practice. Further studies incorporating longitudinal outcomes and time-to-event analyses are warranted to better contextualize these observations. Documented remission in newly diagnosed multiple myeloma by first-line therapy. First-line therapy Patients with documented remission (%) Bortezomib-based 33 Daratumumab-based 46