Carfilzomib, dexamethasone, and daratumumab vs. carfilzomib and dexamethasone for patients with relapsed or refractory multiple myeloma

The combination of carfilzomib plus daratumumab has demonstrated potential as a novel therapy for relapsed or refractory multiple myeloma, but researchers wondered if adding a third drug might be even more promising. In the multinational CANDOR trial, they evaluated outcomes with carfilzomib, dexamethasone, and daratumumab vs. with carfilzomib and daratumumab only. The Phase III study randomized 466 participants in a 2:1 ratio to triple therapy (KdD) or the two-drug combination (Kd). The main outcome was progression-free survival, which was 15.8 months in the Kd group at estimated 17-month followup but had not yet been reached in the KdD patients. The finding suggests that KdD significantly extends progression-free survival compared with Kd in the setting of relapsed or refractory multiple myeloma, although the treatment period was notably longer with KdD. Overall, researchers found the risk-benefit profile for the approach acceptable. The trial remains active, although enrollment has ended.