AURIGA- Dara + Len vs Len Alone as Myeloma Maintenance | Rafael Fonseca, MD | IMS 2024

Hello. Today I would like to tell you about a very important study that was just presented at the plenary session for the International Mildoma Society. The study is called ARIGA. And ARIGA is a randomized phase three study that compared the use of dark tumor plus linoleumide versus linoleumide as maintenance. Now there's a couple of important caveats. Patients were eligible for this trial if they had achieved at least a VGPR, but they had to be MRD positive. So in other words, strictly speaking, this is not for MRD negative patients. Second of all, patients had to be naive. That is, they had to have no prior treatment with CD38 antibodies like the artinoma or isotoxin. So this would be the class of patient coming to a transplant center, say being treated with VRD. The study primary endpoint was conversion of those patients that are positive to negative in their MRD. And not surprisingly, the study was positive. The conversion rate was as high as approximately 60%. That is, you were 60% positive and then converted to negative, which is really a wonderful result. We've learned from this and other clinical trials that an important goal is to try to reach that negativity. Now for patients, I think it's important to know that we can't always do that. But if we have a way or if you have something that you can do that would make it more likely to become negative, in general, I would say that's a good thing. Now it's a better thing when we have treatments such as the artinoma, which is a very well tolerated monoclonal antibody and it doesn't have any major toxicities. We take it carefully, but it's very well tolerated. So I think the study really separates the question. If you have a patient who completes transplant, the MRD positive, give them the artinoma as part of their maintenance approach. And you'll hear that doctors talk about consolidation versus maintenance as just semantics. That's more of effective treatment. So I'm very excited to see those results. They build on what we knew from other clinical trials, which you may have seen in other videos like ASAPIA or Perseus. But it really tells us that what I say is a hashtag you have to finish the job. Thank you.