Daratumumab (12) – Darzalex®

Multiple myeloma, first-line, stem cell transplantation suitable, combination with bortezomib, lenalidomide and dexamethasone

Characteristics

Start date 01.12.2024 – Marketing authorisation: 21.10.2024
Resolution 15.05.2025
INN Daratumumab
Brand name Darzalex®
Pharm. company Janssen-Cilag GmbH
G-BA Procedure ID D-1138
ATC code L01FC01 CD38 inhibitors (L01FC)
ICD-10 codes (AIS) C90.00Multiple myeloma with failed remission, C90.01Multiple myeloma in remission
Alpha-ID codes (AIS) I21328Multiple myeloma, I31059Multiple myeloma in complete remission
ORPHAcodes (AIS) 29073Multiple myeloma,
Therapeutic area Oncological diseases Multiple myeloma (MM) Orphan (turnover limit)
Reason for procedure New therapeutic indication

Therapeutic indication of the resolution

Darzalex is indicated in combination with bortezomib, lenalidomide and dexamethasone for the treatment of adult patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplantation.

Subpopulation Indication Comparator
Adults with newly diagnosed multiple myeloma who are suitable for autologous stem cell transplantation An induction therapy consisting of: - bortezomib + thalidomide + dexamethasone (VTd) or - bortezomib + cyclophosphamide + dexamethasone (VCd) [only for patients with peripheral polyneuropathy or an increased risk of developing peripheral polyneuropathy; cf. Annex VI to Section K of the medicines directive (AM-RL)] or - daratumumab + bortezomib + thalidomide + dexamethasone (D-VTd) - followed by high-dose therapy with melphalan and subsequent autologous stem cell transplantation - followed by consolidation therapy with D-VTd (only if induction therapy with D-VTd is used) - followed by maintenance therapy consisting of: Lenalidomide

Studies and Results

No. of studies
(best subpopulation)
1 (PERSEUS)
Study design
(best subpopulation)
H2H vs. non-ACT + no ITC
Meta analysis
(best subpopulation)
no

  • Clinical trials
    • To assess the additional benefit of daratumumab in combination with bortezomib, lenalidomide and dexamethasone compared with the appropriate comparator therapy, the pharmaceutical manufacturer submitted the ongoing, open-label, randomised PERSEUS trial.

Adults with newly diagnosed multiple myeloma who are suitable for autologous stem cell transplantation

  • The additional benefit is not proven.
  • Overall, the induction and consolidation therapy with VRd administered in the control arm of the PERSEUS trial does not correspond to the appropriate comparator therapy as defined by the G-BA. Consequently, the appropriate comparator therapy has not been implemented in the PERSEUS trial. Consequently, the PERSEUS study is not suitable for assessing the additional benefit of daratumumab + bortezomib + lenalidomide + dexamethasone compared with the appropriate comparator therapy.
  • Consequently, there are no suitable data available to enable an assessment of the additional benefit, which is why an additional benefit of daratumumab in combination with bortezomib, lenalidomide and dexamethasone in the treatment of patients with newly diagnosed multiple myeloma, who are suitable for autologous stem cell transplantation, proof that they are suitable has not been proven.

Courtesy translation only, please refer to the German original.

Associated procedures

Daratumumab (15) Darzalex® Janssen-Cilag GmbH Oncological diseases Smouldering multiple myeloma (SMM) 160–325 100% Hint for minor additional benefit Orphan (turnover limit)
Daratumumab (14) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma, unsuitable for stem cell transplantation, in combination with bortezomib, lenalidomide and dexamethasone 3,450–3,680 100% Hint for minor additional benefit Orphan (turnover limit)
Daratumumab (13) Darzalex® Janssen-Cilag GmbH Oncological diseases Systemic light-chain amyloidosis, first-line, combination with cyclophosphamide, bortezomib and dexamethasone 220–515 100% Hint for considerable additional benefit Orphan (turnover limit)
Daratumumab (12) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma, first-line, stem cell transplantation suitable, combination with bortezomib, lenalidomide and dexamethasone 1,750–1,910 100% additional benefit not proven Orphan (turnover limit)
Daratumumab (11) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma, first-line, stem cell transplantation unsuitable, combination with bortezomib, melphalan and prednisone 3,450–2,680 100% Indication of considerable additional benefit Orphan (turnover limit)
Daratumumab (10) Darzalex® Janssen Oncological diseases Multiple myeloma (MM), after at least 1 previous therapy, combination with lenalidomide and dexamethasone or bortezomib and dexamethasone 4,700–7,000 100% Proof of considerable additional benefit Orphan (turnover limit)
Daratumumab (9) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), newly diagnosed, patients not suitable for autologous stem cell transplantation, combination with lenalidomide and dexamethasone 3,470–3,670 100% Hint for considerable additional benefit Orphan (turnover limit)
Daratumumab (8) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple Myeloma (MM), at least 1 pretreatment, combination with Pomalidomid and Dexamethason 3,190–3,600 38% Hint for minor additional benefit Orphan (turnover limit)
Daratumumab (7) Darzalex® Janssen-Cilag GmbH Oncological diseases Systemic light chain amyloidosis, first-line, combination with cyclophosphamide, bortezomib and dexamethasone 0
440–1,030
50% Hint for minor additional benefit Orphan (turnover limit) repealed
Daratumumab (5) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), newly diagnosed, patients not suitable for autologous stem cell transplantation, combination with lenalidomide and dexamethasone 0
3,479–3,670
100% Hint for minor additional benefit Orphan (turnover limit) repealed
Daratumumab (6) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), newly diagnosed, patients suitable for autologous stem cell transplantation, combination with bortezomib, thalidomide and dexamethasone 1,800–1,900 100% Hint for non-quantifiable additional benefit Orphan (turnover limit)
Daratumumab (4) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), first-line, unsuitable for stem cell transplantation, combination with bortezomib, melphalan and prednisone 0
3,380–3,900
100% Hint for considerable additional benefit Orphan (turnover limit) repealed
Daratumumab (3) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), monotherapy; multiple myeloma, at least 1 prior therapy, combination with lenalidomide and dexamethasone or bortezomib and dexamethasone 2,300
7,000–9,300
72% Indication of considerable additional benefit Orphan (turnover limit) repealed subpopulations
Daratumumab (2) Darzalex® Janssen Cilag GmbH Oncological diseases Multiple myeloma (MM) n.d. discontinued Orphan
Daratumumab (1) Darzalex® Janssen-Cilag GmbH Oncological diseases Multiple myeloma (MM), monotherapy, pre-treated patients 0
2,300
100% non-quantifiable additional benefit Orphan repealed


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