Daratumumab, Pomalidomide and Dexamethasone (DPd) in Relapsed/ Refractory Light Chain Amyloidosis Previously Exposed to Daratumumab

• Published in: Blood 2023-11, Vol.142 (Supplement 1), p.3402-3402
• Main Authors: Rosenbaum, Cara, Liedtke, Michaela, Christos, Paul, Kim, Hyemin, Pogonowski, Kathleen, Agudo, Natalie, Barroso, Bruna, Shelton, Anthony, Reilly, Samantha, Gadbois, Courtney, Sloan, John Mark, Sanchorawala, Vaishali, D'Souza, Anita
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2023-191133

Introduction: Daratumumab (Dara) has changed the treatment paradigm in newly diagnosed and relapsed AL amyloidosis (RAL). Efficacy of Dara retreatment in RAL and Dara reexposure with (w/) effective partners such as IMiDs is unknown. We hypothesize that DPd [Dara, pomalidomide (Pom) and dexamethasone (dex)] in previously Dara exposed RAL patients (pts), including pts with low dFLC (20-50 mg/L), will yield deeper hematologic (hem) responses. Primary objective is to determine hem best response w/in 12 months (mos) of DPd treatment. Secondary objectives include hem overall and very good partial response rates (ORR and VGPR), stringent dFLC response, low-dFLC PR rates (in low dFLC pts only), minimal residual disease (MRD) negative rates using next generation sequencing (NGS), serum mass spectrometry (MS) M protein detection, time to first/ best hem responses, time to next therapy, median hem PFS/OS, organ response rates and duration of/ time to organ response. Methods: Multicenter phase 2 trial w/16 pts planned to receive DPd for 12 cycles. Eligibility include RAL, ≥ 1 prior line, ≥ 8 prior doses of Dara given in any prior line and negative CRAB criteria. Low dFLC pts were eligible w/ adapted response criteria used for low-dFLC PR (dFLC