Evaluating Limited-Duration DRd Treatment in Biochemical and Clinical Relapse of Multiple Myeloma: A Taiwan-Based Analysis

Background: Almost all patients with multiple myeloma eventually relapse. In our national health system, DRd is reimbursed for only 12 cycles, and its adequacy remains unclear. Due to financial constraints, treatment is often delayed until clinical progression. Evidence comparing outcomes of biochemical versus clinical progression–initiated DRd is limited. Materials and methods: We analyzed 56 MM patients treated with DRd after TFDA approval, classified into biochemical vs clinical progression, and assessed PFS outcomes. Results: After a median follow-up of 20.2 months (95% CI, 0.2–74.3), the median PFS was 22.3 months (95% CI, 14–33) in patients who received DRd therapy. The 12‑month PFS rate was 65.4% in the DRd group. Patients treated at biochemical relapse had a longer median PFS (28.2 months) compared with those treated at clinical relapse (19.5 months). Regarding post‑progression survival, patients in the biochemical relapse group had not reached the median, whereas those in the clinical relapse group had a median survival of 30.5 months. In the biochemical relapse group, the overall response rate was 100%. In comparison, the overall response rate in the CP group declined to 82.9%, with only half of the patients achieving ≥VGPR. The average duration of Rd maintenance therapy was 12.1 months. Conclusion: For our source limitation in our national health reimbursement, daratumumab was being used as fixed duration with a period of one year. Intervention under CP showed significant profit for better overall response rate. The disease will finally relapse, therefore, corporate with maintenance therapy will probably benefits from those whose baseline data revealed prominent anemia and the disease control status reached above VGPR.