Abstract
A search of the scientific literature for Daratumumab and myeloma gives more than 600 results (January 2021), which reflects the interest and activity around this antibody, an interest that was also reflected by the assignment of breakthrough designation for Daratumumab as a treatment for multiple myeloma by FDA in 2013. The high expectations have been supported and met due to a very active clinical development program, and our insight into Daratumumab’s modes of action have been expanded by a concomitant, systematic activity of translational research. The scope of this article is to point to some areas where the outcome of treatment with Daratumumab for multiple myeloma may be improved with a focus on areas such as when to initiate treatment with Daratumumab, the use of supportive treatment, duration of therapy and some general thoughts about anti-myeloma treatment as a two-step process involving initial de-bulking followed by reprogramming of the host’s immune system and immune-mediated control of myeloma.
Highlights
This review is based on personal experience with Daratumumab for treatment of multiple myeloma for more than a decade, results from clinical studies and countless interactions with wonderful colleagues in the field
In an update of the POLLUX trail, where Daratumumab was used in combination with lenalidomide and dexamethasone for treatment of relapsed/refractory myeloma, the outcome was far better than what could have been anticipated when comparing with the outcome of second line of therapy in the real world (Table 1) [1,2]
Patients that make it to a second line of therapy in the real world have been selected for their ability to survive
Summary
This review is based on personal experience with Daratumumab for treatment of multiple myeloma for more than a decade, results from clinical studies and countless interactions with wonderful colleagues in the field. The intention is to point at some areas where the outcome of treatment may be further improved and to stimulate thoughts and discussions about areas of uncertainties with the hope of gaining optimal benefit from treatment with Daratumumab for our patients in the future
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