Would you consider daratumumab monotherapy as standard of care for smoldering multiple myeloma based on the AQUILA trial?

AQUILA is out! There MIGHT be a survival advantage (p<0.05) to early intervention, but to avoid p-hacking all we have now is a healthy hazard ratio and a confidence interval that juts right up to 1 - it was 0.97.

If a patient meets the criteria for this trial, considering Dara makes some sense. I do...

Based on the findings of the AQUILA trial, I believe it is reasonable to consider treating only high-risk patients with smoldering myeloma using Daratumumab. This decision would, of course, follow thorough counseling with the patient, ensuring they fully understand the rationale behind the treatment...

Very little to add to the excellent answers by @Dr. First Last and @Dr. First Last except to emphasize that patient counseling will be key. The only thing more heterogeneous than multiple myeloma is smoldering myeloma, both in terms of disease biology but also in terms of patient-specific factors, v...