(PA-398) Overview of First-Line Treatment of Multiple Myeloma Patients from Two Hematology Centers in Slovakia – Data from the RMG Registry

Introduction:  The treatment landscape for multiple myeloma (MM) has undergone significant changes in recent years. The introduction of the monoclonal anti-CD38 antibody daratumumab into first-line regimens has to led to substantial improvements in response rate. The primary aim of this was to evaluate the maximum response and safety of daratumumab-based regimens in the first-line treatment of MM, based on data from the register of monoclonal gammopathy (RMG). The secondary goal was to highlight the importance of  systematic data collection in patients with monoclonal gammopathies in routine clinical practice.

Methods:   A total of 124 patients treated in the first line with daratumumab-based regimens (DVTD,DVMP,DRD,DVRD) between 2023 and 2025 in Two Hematology centers in Slovakia, were included in this analysis. The median age at diagnosis was 65 years (range 36-83), with the majority of patients being male (66; 53.2%) and female (54; 46.8%). Data were analyzed using statistical methods from the RMG registry. We assessed the maximum overall response according to the IMWG criteria and compared it with a historical cohort of 816 patients treated with non- daratumumab regimens (VRD,CVD,VTD,RD,VMP and others) between 2007 and 2022 at our centers. Adverse events were assessed based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

Results:   The analysis confirmed the superior efficacy and safety of daratumumab-based regimens in the first-line treatment of MM, showing higher response rates compared to non-daratumumab regimens. In patients eligible for autologous stem cell transplantation (ASCT), achieving a maximum response of VGPR or better was 92.7% vs.73.4% (p= 0.0004). In patients not eligible for ASCT, the response rate was 83.7% vs.40.3% (p=0.0000). Daratumumab regimens were well tolerated and could be fully administered on an outpatient basis.

Conclusions:   The inclusion of daratumumab in induction therapy significantly improves the depth of response in MM patients, with regimens being well-tolerated and suitable for outpatient treatment. The RMG registry proves valuable for tracking diagnosis and treatment outcomes in clinical practice, facilitating access to analytical data for collaborative publications, scientific collaboration, regulatory arguments, and the development of joint guidelines for diagnosis and treatment. The RMG project is fully open for collaboration with all oncology centers and groups in Slovakia, the Czech Republic, and other European countries.