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.

Extended induction and consolidation therapy with daratumumab-based regimens significantly improve 5-year progression-free and overall survival in high-risk multiple myeloma patients, with median PFS not reached.

• Why it matters: High-risk multiple myeloma remains difficult to treat, with poor long-term outcomes despite current therapies, highlighting the need for more effective, tailored treatment strategies.
• What they did: The phase 2 OPTIMUM trial enrolled 108 high-risk patients, administering intensive daratumumab-based induction, consolidation, and maintenance therapy, and compared outcomes with an external control cohort from Myeloma XI.
• The result: Patients receiving the intensified regimen experienced markedly longer progression-free survival (not reached vs. 24.4 months) and overall survival (not reached vs. 57.4 months), supporting personalized, risk-stratified treatment approaches.