DVd demonstrates faster response, superior 12-month progression-free survival and duration of response, with relatively less toxicity compared to VRd in newly diagnosed multiple myeloma patients in a multicenter propensity score-matched real-world analysis.
DVd achieved faster time to response than VRd in the original cohort despite worse baseline characteristics.
Overall response rates were comparable between DVd and VRd in both the original and propensity score-matched cohorts.
DVd demonstrated superior 12-month progression-free survival compared to VRd in both the original and PSM cohorts.
DVd demonstrated superior 12-month duration of response compared to VRd in both the original and PSM cohorts.
DVd showed comparable renal response to VRd despite significantly lower baseline eGFR in the DVd group.
DVd had relatively fewer severe adverse reactions than VRd, though differences did not reach statistical significance.
Propensity score matching on age, serum creatinine, Durie-Salmon stage, and ISS stage generated a balanced cohort of 70 patients per group from the original 206 patients.
This research suggests that daratumumab-bortezomib-dexamethasone (DVd), a three-drug combination including the antibody drug daratumumab, may be a better frontline treatment option than the standard lenalidomide-bortezomib-dexamethasone (VRd) regimen for patients newly diagnosed with multiple myeloma. In a real-world study of 206 patients across 12 hospitals in China, DVd patients responded faster to treatment (about 1.85 months versus 2.27 months) and had better outcomes over 12 months: approximately 93% of DVd patients had not experienced disease progression at 12 months compared to 79% of VRd patients. Importantly, these DVd benefits were seen even though DVd patients started with worse kidney function and other more challenging disease characteristics. The study also found that both treatments achieved similarly high overall response rates (around 97%) and comparable rates of deep remission once patient groups were statistically balanced through a technique called propensity score matching. Regarding kidney function — an important concern in myeloma — DVd patients showed comparable kidney recovery to VRd patients despite starting with lower kidney function. Additionally, DVd was associated with numerically fewer severe side effects (such as low white blood cell counts, low platelet counts, and liver enzyme elevations), though these differences were not statistically significant. This research suggests that DVd could serve as a valuable frontline treatment option for newly diagnosed multiple myeloma patients, potentially offering advantages for specific groups including those with high-risk genetic features, advanced disease stage, and patients eligible for stem cell transplantation. The authors note that DVd may be particularly relevant for patients who are poorly suited for the quadruplet daratumumab-VRd regimen, such as elderly or frail individuals and those with significant kidney impairment. These findings are based on real-world clinical practice data rather than a randomized controlled trial, which is an important limitation to consider.
Jiang H, Li Q, Wang L, Dou X, Leng Q, Miao M, et al.. (2026). Superior 12-month progression-free survival with frontline DVd versus VRd in patients with newly diagnosed multiple myeloma: a multicenter propensity score-matched analysis.. Journal of translational medicine. https://doi.org/10.1186/s12967-026-08637-6