Al-Ola A Abdallah, Associate Professor and Plasma Cell Disorder Program Director of the Division of HMCT at the University of Kansas Medical Center, shared a post on X:
“ANDROMEDA final analysis is practice-changing for newly diagnosed AL amyloidosis.
IMPORTANT tweets: 3/4 and 6 for clinicians who treats Amyloidosis
D-VCd = daratumumab + bortezomib/cyclophosphamide/dexamethasone.
With 61.4 months median follow-up, D-VCd improved depth of response, organ recovery, MOD-PFS, and OS.
Key efficacy signal:
- Hematologic CR: 59.5% with D-VCd vs 19.2% with VCd
- OR 6.03; P<0.0001
- VGPR or better: 79.0% vs 50.3%
This is not just more responses – it is deeper responses.
Speed matters in AL amyloidosis, especially cardiac AL.
Median time to hematologic CR:
D-VCd: 67.5 days: 85 days
Median time to first hematologic response: 11 days vs 23 days
Rapid light-chain control saves organs.
Organ responses were clearly better with D-VCd.
Cardiac and renal response rates were ~2–3x higher with D-VCd across 6, 12, 24, 36, and 48 months. Cardiac CR: 40.7% with D-VCd 13.7% with VCd That is clinically meaningful.
The survival data now solidify the regimen. Major organ deterioration–PFS: HR 0.44 95% CI 0.31–0.63 P<0.0001 Overall survival: HR 0.62 95% CI 0.42–0.90 P=0.0121 D-VCd is not only improving response – it is improving survival.
Estimated 5-year OS: D-VCd: 76.1% VCd: 64.7% Median OS was not reached in either arm. For a disease historically driven by early organ failure, this is a major advance.
Important clinical message: Achieving hematologic CR or cardiac CR was associated with better MOD-PFS and OS, regardless of treatment arm. But D-VCd produced these deep responses much more often. Depth of response remains central in AL amyloidosis.
Safety: no new major signal with longer follow-up.
Common grade 3/4 AEs included:
- Lymphopenia
- Pneumonia
- Cardiac failure
- Neutropenia
- Syncope
- Fatigue
Interpret AE rates in context: D-VCd had much longer treatment exposure.
Clinician takeaway:
For eligible patients with newly diagnosed AL amyloidosis, D-VCd is further confirmed as standard frontline therapy. The goal is early, deep hematologic response -organ recovery – survival benefit. ANDROMEDA final analysis raises the bar.
NEXT STEP BCMA directed therapies.”
Title: Daratumumab-Bortezomib-Cyclophosphamide-Dexamethasone in Newly Diagnosed Amyloidosis: ANDROMEDA Final Survival Analysis
Authors: Efstathios Kastritis, Giovanni Palladini, Monique C Minnema, Ashutosh D. Wechalekar, Arnaud Jaccard, Hans C Lee, Vaishali Sanchorawala, Peter Mollee, Jin Lu, Stefan O. Schönland, Moshe E Gatt, Kenshi Suzuki, Kihyun Kim, M Teresa Cibeira,
Manisha Bhutani, Meral Beksac, Edward N. Libby, Jason Valent, Vania Hungria, Michael A Rosenzweig, Naresh Bumma, Antoine Huart,
Meletios-Athanasios A. Dimopoulos, Divaya Bhutani, Adam Waxman, Stacey Goodman, Jeffrey A. Zonder, Selay Lam,
Kevin W. Song, Timon Hansen, Salomon Manier, Wilfried W.H. Roeloffzen, Krzysztof Jamroziak, Fiona Kwok, Chihiro Shimazaki, Jin-Seok Kim, Edvan de Queiroz Crusoé, NamPhuong Tran, Jianping Wang, Yuping Chen, Sandra Y. Vasey, Jordan M Schecter, Jessica Vermeulen, Raymond Comenzo, Giampaolo Merlini
Read the full article on Blood.
Other articles featuring Al-Ola A Abdallah on OncoDaily.
