Induction and extended consolidation with daratumumab, cyclophosphamide, bortezomib, lenalidomide, and dexamethasone in patients with high-risk multiple myeloma (OPTIMUM/MUKnine): 5-year follow-up of a multicentre, externally controlled, phase 2 trial.
Lancet OncolSep 7, 2026 (epub)
Martin F Kaiser, Rachel H Phillip, Sarah R Brown et al.
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In 30 seconds
The OPTIMUM trial, a multicentre, phase 2 study, evaluated the effects of intensified induction and extended consolidation therapy in 107 patients with high-risk multiple myeloma. At 5 years, progression-free survival was not reached in the OPTIMUM cohort compared to 24.4 months in the Myeloma XI external control (HR 0.32, p<0.0001), indicating significant survival benefits from the treatment regimen.
Key findings
- Progression-free survival was not reached in OPTIMUM vs 24.4 months in Myeloma XI (HR 0.32, p<0.0001).
- Overall survival was not reached in OPTIMUM vs 57.4 months in Myeloma XI (HR 0.43, p<0.0001).
- Median progression-free survival 2 was not reached in OPTIMUM vs 43.9 months in Myeloma XI (HR 0.26, p<0.0001).
- Survival benefits were consistent across most high-risk subgroups, except for patients with three or more HRCAs.
Why it matters
This study highlights the potential for improved long-term outcomes in high-risk multiple myeloma through tailored treatment strategies, emphasizing the importance of molecular diagnostics in guiding therapy.