Results of a Double-Blind Prospective Comparative Randomized Phase 3 Clinical Trial of the Efficacy and Safety of BCD-264 and Darzalex as Monotherapy for Relapsed/Refractory Multiple Myeloma (BCD-264-2/DARVIVA)

T.V. Shelekhova, J. Kumar, S.J. Apte, Iu.S. Osipov, E.N. Misyurina, V.A. Doronin, T.S. Konstantinova, B.A. Bakirov, A.V. Proidakov, A.L. Uss, M. Kumar, E.V. Martynova, N.G. Chernova, M.A. Khokhar, A.D. Garifullin, C.R. Ross, S.L. Cyriac, S.V. Voloshin, M.A. Ulyanova, N.A. Falaleeva, N.A. Katin, D.V. Kirtbaya, M.O. Kiseleva, E.Yu. Komarceva, A.A. Myasnikov, D.K. Novik, M. Shabbir-Moosajee, S.V. Samarina, V.V. Denisova, G.N. Khusainova, T.K. Dolai, B. Bagchi, I.S. Zyuzgin, I.S. Moiseev, T.I. Pospelova, A.A. Semenova, M.A. Novikova, I.L. Davydkin, M.V. Kosinova, A.M. Pavlova, N. Sidharthan, H. Mukhopadhyay, A. Wahid, Q.M. Buttar, Yu.N. Linkova, A.V. Zinkina-Orikhan, Svyatoslav Vladimirovich Nechaev, A.S. Shadrina, A.A. Lutckii, D.O. Liaptseva,

DOI:

https://doi.org/10.21320/2500-2139-2026-19-2-119-130

AIM. To confirm the comparability of the biosimilar daratumumab BCD-264 (BIOCAD) with the reference drug Darzalex (Johnson & Johnson) in terms of efficacy and safety of the monotherapy for relapsed/refractory (r/r) multiple myeloma (MM).

MATERIALS & METHODS. This paper is based on the double-blind prospective comparative randomized phase 3 clinical trial BCD-264-2/DARVIVA assessing the efficacy and safety of BCD-264 and Darzalex as monotherapy for r/r MM. Duration of the blind period was 24 weeks. The trial enrolled 252 r/r MM patients treated with proteasome inhibitors and immunomodulatory drugs. This paper documents the analysis of the data collected within the blind period when the therapy was administered to Group 1 and Group 2, whereby neither the investigators nor the patients knew which drug is being used in each of the groups.

RESULTS. The primary end point of the study was overall response rate (ORR) in 24 weeks after therapy onset. In Group 1, ORR was 36.2 % and it was 32.0 % in Group 2; ORR ratio for Group 1/2 was 1.13 (95% confidence interval [95% CI] 0.80–1.60) and 0.88 (95% CI 0.63–1.24) for Group 2/1. This confirmed the hypothesis of BCD-264 being no less effective than Darzalex. Besides, an additional hypothesis of drug equivalence was proved true demonstrating also the comparability of the drugs across all secondary efficacy end points and safety parameters. The most common adverse events reported in both groups were leukopenia, neutropenia, lymphopenia, anemia, thrombocythemia, infusion-associated reactions, and pneumonia.

CONCLUSION. Both drugs BCD-264 and Darzalex showed comparable efficacy and safety during the 24-week period in the BCD-264-2/DARVIVA trial as well as comparable immunogenicity and pharmacokinetic profile.

  1. Множественная миелома, клинические рекомендации. Под ред. Л.П. Менделеевой, М.В. Соловьева, И.Г. Рехтина. (электронный документ) Доступно по: https://cr.minzdrav.gov.ru/preview-cr/144_2. Ссылка активна на 20.01.2026. [Mendeleeva L.P, Solovev M.V., Rekhtin I.G., eds. Multiple Myeloma. Clinical Guidelines. (Internet) Available from: https://cr.minzdrav.gov.ru/preview-cr/144_2. Accessed 20.01.2026. (In Russ)]
  2. Dimopoulos M, Terpos E, Boccadoro M, et al. EHA-EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma. Nat Rev Clin Oncol. 2025;22(9):680–700. doi: 10.1038/s41571-025-01041-x. DOI: https://doi.org/10.1038/s41571-025-01041-x
  3. Kumar S, Dimopoulos M, Kastritis E, et al. Natural history of relapsed myeloma, refractory to immunomodulatory drugs and proteasome inhibitors: a multicenter IMWG study. Leukemia. 2017;31(11):2443–8. doi: 10.1038/leu.2017.138. DOI: https://doi.org/10.1038/leu.2017.138
  4. Donk N, Moreau P, Plesner T, et al. Clinical efficacy and management of monoclonal antibodies targeting CD38 and SLAMF7 in multiple myeloma. Blood. 2016;127(6):681–95. doi: 10.1182/blood-2015-10-646810. DOI: https://doi.org/10.1182/blood-2015-10-646810
  5. Usmani S, Nahi H, Plesner T, et al. Daratumumab monotherapy in patients with heavily pretreated relapsed or refractory multiple myeloma: final results from the phase 2 GEN501 and SIRIUS trials. Lancet Haematol. 2020;7(6):e447–e455. doi: 10.1016/S2352-3026(20)30081-8. DOI: https://doi.org/10.1016/S2352-3026(20)30081-8
  6. Htut T, Thein K, Laweie A, et al. Efficacy of daratumumab combination regimen in patients with multiple myeloma: A combined analysis of phase III randomized controlled trials. EJHaem. 2020;1(1):262–6. doi: 10.1002/jha2.46. DOI: https://doi.org/10.1002/jha2.46
  7. Dimopoulos A, Oriol A, Nahi H, et al. Overall Survival With Daratumumab, Lenalidomide, and Dexamethasone in Previously Treated Multiple Myeloma (POLLUX): A Randomized, Open-Label, Phase III Trial. J Clin Oncol. 2023;41(8):1590–9. doi: 10.1200/JCO.22.00940. DOI: https://doi.org/10.1200/JCO.22.00940
  8. Гальцева И.В., Никифорова К.А., Давыдова Ю.О. и др. Множественная миелома: нюансы диагностики и мониторинга минимальной остаточной болезни методом многоцветной проточной цитометрии. Клиническая онкогематология. 2022;15(4):365–76. doi: 10.21320/2500-2139-2022-15-4-365-376. [Galtseva I.V., Nikiforova K.A., Davydova Yu.O., et al. Multiple Myeloma: Nuances of Minimal Residual Disease Diagnosis and Monitoring with the Use of Multicolor Flow Cytometry. Clinical oncohematology. 2022;15(4):365–76. doi: 10.21320/2500-2139-2022-15-4-365-376. (In Russ)] DOI: https://doi.org/10.21320/2500-2139-2022-15-4-365-376
  9. Gunnam S, Fathema K, Nijhawan M, et al. A Review on Economic Benefits and Impact of Biosimilars on Healthcare System. J Pharma Insights Res. 2025;3(4):181–90. doi: 10.69613/8mvctk45. DOI: https://doi.org/10.69613/8mvctk45
  10. Qian J. Uptake of Rituximab Biosimilars in Medicare and Medicaid in 2019–2022. Am J Manag Care. 2024;30(12):e359–e363. doi: 10.37765/ajmc.2024.89644. DOI: https://doi.org/10.37765/ajmc.2024.89644
  11. Khan M, Esba L, Yousf C, et al. Practical challenges and considerations in adopting biosimilars in oncology clinical practice within a large healthcare system. Expert Rev Clin Pharmacol. 2025;18(6):323–31. doi: 10.1080/17512433.2025.2492063. DOI: https://doi.org/10.1080/17512433.2025.2492063
  12. Guideline on similar biological medicinal products (Rev.1). Adopted Reference Number: CHMP/437/04 Rev.1. Available from: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-similar-biological-medicinal-products-rev1_en.pdf (accessed 20.01.2026).
  13. Scientific Considerations in Demonstrating Biosimilarity to a Reference Product. Available from: https://www.fda.gov/media/82647/download (accessed 20.01.2026).
  14. Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863–9. doi: 10.1200/JCO.2015.61.2267. DOI: https://doi.org/10.1200/JCO.2015.61.2267
  15. Rajkumar S, Dimopoulos M, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538–е548. doi: 10.1016/S1470-2045(14)70442-5. DOI: https://doi.org/10.1016/S1470-2045(14)70442-5
  16. Kumar S, Paiva B, Anderson K, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17(8):e328–e346. doi: 10.1016/S1470-2045(16)30206-6. DOI: https://doi.org/10.1016/S1470-2045(16)30206-6
  17. Schuirmann D. A comparison of the two one-sided tests procedure and the power approach for assessing the equivalence of average bioavailability. J Pharmacokinet Biopharm. 1987;15(6):657–80. doi: 10.1007/BF01068419. DOI: https://doi.org/10.1007/BF01068419
  18. Дарзалекс (инструкция по медицинскому применению). (электронный документ) Доступно по: https://lk.regmed.ru/Register/EAEU_SmPC. Ссылка активна на 20.01.2026. [Darzalex (package insert). (Internet) Available from: https://lk.regmed.ru/Register/EAEU_SmPC. Accessed 20.01.2026. (In Russ)]
  19. Решение Совета ЕЭК от 03.11.2016 г. № 89 «Об утверждении Правил проведения исследований биологических лекарственных средств Евразийского экономического союза». (электронный документ) Доступно по: https://eec.eaeunion.org/comission/department/deptexreg/formirovanie-obshchikh-rynkov/akty-v-sfere-ls.php. Ссылка активна на 20.01.2026. [Decision No. 89 of the Eurasian Economic Commission’s Council dated November. 3, 2016 “Rules for Conducting Studies of Biological Medicinal Products of the Eurasian Economic Union”. (Internet) Available from: https://eec.eaeunion.org/comission/department/deptexreg/formirovanie-obshchikh-rynkov/akty-v-sfere-ls.php. Accessed 20.01.2026. (In Russ)]
  20. Lokhorst H, Plesner T, Laubach J, et al. Targeting CD38 with Daratumumab Monotherapy in Multiple Myeloma. N Engl J Med. 2015;373(13):1207–19. doi: 10.1056/NEJMoa1506348. DOI: https://doi.org/10.1056/NEJMoa1506348
  21. Lonial S, Weiss B, Usmani S, et al. Daratumumab monotherapy in patients with treatment-refractory multiple myeloma (SIRIUS): an open-label, randomised, phase 2 trial. Lancet. 2016;387(10027):1551–60. doi: 10.1016/S0140-6736(15)01120-4. DOI: https://doi.org/10.1016/S0140-6736(15)01120-4

Downloads

Download data is not yet available.

For Contact

  • Svyatoslav Vladimirovich Nechaev,  , BIOCAD, 38 korp. 1 Svyazi ul., Strelna pos., Saint Petersburg, Russian Federation, 198515, e-mail: nechaevs@biocad.ru

Published

01.04.2026

Issue

CLINICAL TRIALS

How to Cite

Shelekhova T.V., Kumar J., Apte S.J., et al. Results of a Double-Blind Prospective Comparative Randomized Phase 3 Clinical Trial of the Efficacy and Safety of BCD-264 and Darzalex as Monotherapy for Relapsed/Refractory Multiple Myeloma (BCD-264-2/DARVIVA). Clinical Oncohematology. Basic Research and Clinical Practice. 2026;19(2):119–130. doi:10.21320/2500-2139-2026-19-2-119-130.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>