According to results from the phase 3 AURIGA study, adding subcutaneous daratumumab to lenalidomide maintenance therapy after autologous stem cell transplant (ASCT) significantly improved minimal-residual disease (MRD)-negative conversion and durability among newly diagnosed multiple myeloma patients who were MRD-positive post-transplant. 

These results were shared by Mitul Gandhi, MD, Virginia Cancer Specialists, Manassas, Virginia at the 2025 ASH Annual Meeting & Exposition. 

At a median follow-up of 40 months, daratumumab plus lenalidomide maintenance more than doubled MRD-negative conversion rates and achieved nearly a tenfold increase in sustained MRD negativity compared with lenalidomide alone. 

Transcript:

My name is Mitul Gandhi. I'm a medical oncologist at Virginia Cancer Specialists, and I'm discussing the AURIGA abstract here at ASH 2025.

AURIGA was a clinical trial taking patients with newly diagnosed multiple myeloma who had received induction therapy with the VRD regimen of bortezomib, lenalidomide dexamethasone, and then were consolidated with an autologous stem cell transplant and achieved a very good partial response or better. Those patients were then assessed for MRD, or measurable residual disease. Patients who are MRD-positive were then randomized into 1 of 2 maintenance arms of lenalidomide or lenalidomide plus daratumumab, the anti-CD38 antibody, an effort to see if they would be converted into an MRD-negative state.

What was presented at this year's ASH conference was that the arm that contained lenalidomide and daratumumab had higher rates of conversion to MRD-negative state compared to the lenalidomide arm alone, roughly 60% versus 30%. Additionally, it was found that the patients who are on the lenalidomide and daratumumab arm had higher rates of sustained MRD negativity at 12 months compared to the arm of lenalidomide alone. What this translated to was a trend towards an improved progression-free survival benefit. It validates the established use of MRD negativity as a surrogate for long-term outcome. Additionally, in this particular trial, they looked at 2 different levels of MRD negativity at 1 x 10^-5, and then at 1 x 10^-6. At both levels, the daratumumab-lenalidomide containing maintenance arms were able to achieve higher rates of MRD negativity, both that 1x10^-5 and 1x10^-6. If you did achieve interestingly MRD negativity at 1x10^-6 independent of which arm you achieved it on, outcomes tended to be favorable.

In conclusion, this study, the AURIGA study presented at ASH in 2025 shows incorporation of anti-CD38 antibody daratumumab on lenalidomide maintenance improves conversion to MRD negativity for patients who are consolidated with autologous stem cell transplant.

Source:

Chung A, Anderson L, Foster L, et al. Minimal residual disease dynamics in post-transplant patients with newly diagnosed multiple myeloma who received daratumumab plus lenalidomide versus lenalidomide alone as maintenance therapy in the auriga study. Dec 6-9, 2025; Orlando, FL. Abstract: 97