Real-World Utilization of Daratumumab in Front-Line Treatment of Newly Diagnosed Multiple Myeloma Across a Regional Academic-Community Network.

BACKGROUND

The addition of CD-38 monoclonal antibody daratumumab (DARA) to front-line therapy for newly diagnosed multiple myeloma (NDMM) has improved outcomes. The real-world (RW) adoption of treatments remains inconsistent. We aimed to evaluate the adoption of DARA regimens in the treatment of NDMM.

METHODS

We conducted a retrospective study at a multi-site academic-community healthcare system from August 2020-September 2023. Patients (n = 414) were ≥18 years with NDMM upon initiating front-line therapy.

RESULTS

The median age was 69; most were male (60.6%, n = 251), white (69.1%, n = 286), and non-Hispanic (89.6%, n = 371). At diagnosis, 52.2% (n = 216) had R-ISS stage II, and the performance status was preserved, with 69.3% (n = 287) having ECOG 0-1. The adoption of DARA-based induction was incomplete (53.9%, n = 223) and was higher at the academic myeloma center than the community sites (63.9% vs. 47.7%; p = 0.001). At three months after treatment initiation, patients receiving DARA-based induction achieved deeper responses than those treated without DARA. The distribution of IMWG responses favored the DARA group, with a higher proportion attaining VGPR or better (65.0% [n = 145] vs. 51.3% [n = 98]).

CONCLUSIONS

DARA-based regimens for NDMM were underutilized and notably less common at community sites. Coordinated implementation strategies at the provider and community levels may narrow adoption gaps and translate trial-proven benefits into routine practice.