A new four-drug treatment has proven to be highly effective and safe, according to the results of the ADVANCE clinical trial presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting.
What’s New?
Researchers reported that adding the targeted therapy daratumumab to the standard three-drug regimen (carfilzomib, lenalidomide, and dexamethasone—known as KRd) significantly improved outcomes for patients. This new combination, called DKRd, is now being recognized as a new standard of care for newly diagnosed multiple myeloma.
Key Study Findings
- Higher Remission Rates: After eight cycles of treatment, 59% of patients on DKRd had no detectable disease (MRD-negative), compared to 36% on KRd alone.
- Longer Remission: At nearly three years of follow-up, 86% of DKRd patients were alive without disease progression, versus 79% for KRd.
- No Major Increase in Side Effects: Adding daratumumab did not cause more serious side effects, thanks in part to careful patient screening.
What Does This Mean for Patients?
- Better First Treatment: Doctors say your best chance for a strong response is with your first treatment. The new four-drug combo gives patients a better shot at deep remission right away.
- Fewer Upfront Transplants: Many patients who achieved MRD-negativity with DKRd were able to delay stem cell transplant and continue with maintenance therapy instead.
- Already in Use: Leading cancer centers are already using DKRd as the go-to first treatment for eligible patients.
How Does the Combo Work?
- Carfilzomib (Kyprolis): Blocks cancer cell protein recycling.
- Lenalidomide (Revlimid): Boosts the immune system’s attack on cancer.
- Dexamethasone: Reduces inflammation and helps control the disease.
- Daratumumab: Targets a protein (CD38) on myeloma cells, helping the immune system destroy them.
What’s Next?
Researchers are continuing to study why some tumors respond better than others and are planning new trials with even more advanced immunotherapies.
If you or a loved one has been newly diagnosed with multiple myeloma, ask your care team about the latest treatment options, including the DKRd combination. This new approach may help you achieve a deeper remission with fewer side effects and could change the way your treatment is planned.
More Reading
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Reference
Landgren CR, Ye JC, Hillengass J, et al. Randomized, multi-center study of carfilzomib, lenalidomide, and dexamethasone (KRd) with or without daratumumab (D) in patients with newly diagnosed multiple myeloma (NDMM): The ADVANCE clinical trial. JCO 2025;43:16_suppl.7503.
