PS-238 (d) Daratumumab, Bortezomib and Dexamethasone (DVd) vs Bortezomib and Dexamethasone (Vd) in RRMM Based on Prior Lines and Treatment Exposure: CASTOR Suzanne Lentzsch, 1 Ajay Nooka, 2 Hang Quach, 3 Cindy Lee, 3 Wolney Barreto, 3 Paolo Corradini, 4 Chang Ki Min, 5 Emma Scott, 3 Asher Chanan-Khan, 6 Noemi Horvath, 3 Marcelo Capra, 3 Meral Beksac, 3 Roberto Ovilla, 3 Jae-Cheol Jo, 7 Ho-Jin Shin, 8 David Soong, 3 Tineke Casneuf, 3 Christopher Chiu, 9 Xiang Qin, 3 Himal Amin, 3 Pieter Sonneveld, 10 Jordan Schecter, 11 Kate Sasser, 9 Ming Qi, 3 Maria-Victoria Mateos 12 1 Division of Hematology/Oncology, Columbia University, New York, NY; 2 Emory University, Winship Cancer Institute, Atlanta, GA; 3 Department of Haematology, St. Vincent’s Hospital, Melbourne, Australia; 4 Italian Multiple Myeloma Network, GIMEMA, Italy; 5 Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea; 6 Mayo Clinic, Jacksonville, FL; 7 Ulsan University Hospital; 8 Pusan National University Hospital; 9 Janssen Research & Develop- ment LLC, PA; 10 Department of Hematology, Erasmus Medical Center, Rotterdam, Netherlands; 11 Janssen Pharmaceutical Research & Development; 12 Hospital Universitario Salamanca Introduction: To determine whether DVd provides superior treatment benefit vs Vd in patients who have relapsed or become refractory to established standard of care regimens, subgroup ana- lyses were performed based on an updated analysis of CASTOR. Methods: All patients received 1 prior line of therapy (LOT) and were administered 8 cycles (Q3W) of Vd (Days 1, 4, 8, 11 for bortezomib 1.3 mg/m 2 SC; Days 1-2, 4-5, 8-9, and 11-12 for dexamethasone 20 mg PO)  daratumumab (16 mg/kg IV once weekly in Cycles 1-3, every three weeks for Cycles 4-8, then every 4 weeks until progression). Bortezomib-refractory patients were inel- igible. High cytogenetic risk (determined using next generation sequencing) was defined as having any of t(4;14), t(14;16), or del17p abnormalities. Results: Patients received a median (range) of 2 (1-10) prior LOT. 66% were bortezomib-pretreated and 21% were refractory to lenalidomide at last prior LOT. With median follow-up of 13.0 months, PFS was significantly prolonged with DVd vs Vd (median not reached [NR] vs 7.1 mo; HR, 0.33; 95% CI, 0.26-0.43; P<0.0001). PFS benefit was observed for DVd in patients with 1 prior LOT (median NR vs 7.9 mo; HR, 0.22; 95% CI, 0.14-0.34; P<0.0001) and 2 to 3 prior LOT (median 9.8 vs 6.3 mo; HR, 0.51; 95% CI, 0.36-0.73; P¼0.0002). DVd was associated with superior PFS for all patients who received study treatment regardless of time since last LOT: median PFS was NR vs 9.4 mo (HR, 0.27; 95% CI, 0.17-0.43; P<0.0001) if treated >12 months after last prior treat- ment; for those treated 12 months after last prior treatment, median PFS was 10.3 mo for DVd vs 5.2 mo for Vd (HR, 0.34; 95% CI, 0.24-0.48; P<0.0001). ORR was numerically higher for DVd vs Vd in the >12 month subgroup (91% vs 83%; P¼0.0632) and signif- icantly higher for DVd vs Vd in the 12 month subgroup (77% vs 49%; P<0.0001). Among bortezomib-pretreated patients, PFS was significantly prolonged with DVd vs Vd (median: 12.4 vs 6.7 months; HR, 0.37; 95% CI, 0.28-0.50; P<0.0001). In patients who received 1 prior LOT which included bortezomib, median PFS was NR in DVd and 8.0 months in Vd (HR, 0.23; 95% CI, 0.13-0.41; P<0.0001). ORR was significantly higher with DVd vs Vd in bor- tezomib-pretreated patients (81% vs 60%; P<0.0001), with deeper responses with higher minimal residual disease (MRD)-negative rates (6% vs 1% at 10e5 sensitivity; P¼0.0056). In patients refractory to lenalidomide at last prior LOT, PFS was significantly longer in DVd vs Vd (median: 9.3 vs 4.4 mo; HR, 0.36; 95% CI, 0.22-0.58; P<0.0001). Higher ORR (81% vs 50%; P¼0.0021) and MRD- negative rates (9% vs 0% at 10e5 sensitivity; P¼0.0082) was observed with DVd vs Vd. Additional efficacy data, including ana- lyses by cytogenetic risk and MRD status, will be presented at the meeting. Conclusions: DVd is superior to Vd regardless of prior LOT, time since last therapy, prior exposure to bortezomib, or refractoriness to lenalidomide. PS-239 Real-World Treatment Patterns in Relapsed or Refractory Multiple Myeloma: Evidence from a Medical Chart Review in the United Kingdom Huamao Mark Lin, 1 Keith Davis, 2 James Kaye, 3 Katarina Luptakova, 1 Gao Lu, 4 Saurabh Nagar, 5 Brian Seal 1 1 Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd., Cambridge, MA; 2 RTI Health Solutions, Research Triangle Park, NC; 3 RTI Health Solutions, Wal- tham, MA; 4 Millennium Pharmaceuticals, Inc., a wholly owned sub- sidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; 5 RTI Health, Research Triangle Park, NC Introduction: Improvement in outcomes in relapsed/refractory multiple myeloma (RRMM) remains an area of unmet need, yet there is a shortage of data describing typical management of these patients in real-world settings. Such data may inform health tech- nology assessments and other regulatory evaluations of RRMM therapies. To help address this information gap, we analyzed data from an RRMM cohort in the United Kingdom (UK). Methods: A retrospective medical record review was conducted in 216 patients with RRMM in the UK. All patients were 18 years of age at initial MM diagnosis and first diagnosed with RRMM (during or following first-line induction therapy) between 01-Jan-2009 and 31-Dec-2011. Patients were retrospectively assessed on second- and third-line treatment regimens received, treatment duration, and reasons for treatment discontinuation from date of first relapse/ progression (i.e., RRMM diagnosis). Results: Mean (SD) age at first relapse was 65.6 (8.7) years, with approximately half (53%) having advanced age (65 years). The sample was 63% male and 69% were still alive at the time of medical record review. Among all patients, 208 (97%) received 1 line of chemotherapy after first relapse; 94 (43%) received 2 lines after first relapse. The most Abstracts 16th International Myeloma Workshop March 1-4, 2017 - e133