Retrospective Observational Study from the Experience in Our Center of the Employment of Daratumumab in Multiple Myeloma

Abstract

INTRODUCTIONDaratumumab is an anti-CD38 monoclonal antibody which is a recent success in the treatment of multiple myeloma (MM). It binds to the CD38 protein, which is highly expressed in MM tumor cells.It is indicated in monotherapy in patients with relapsed MM, being refractory to treatment and having previously received a proteasome inhibitor and an immunomodulatory agent, with progression of the disease since the last treatment.It can also be used, as stated recently in its data sheet, in combination with Lenalidomide and Dexamethasone or Bortezomib and Dexamethasone for the treatment of patients with MM who have received at least one previous treatment. It is being tested in combination with other drugs, which shows its enormous potential.OBJECTIVESWe expose the experience with this drug in our center in recent years.MATERIALS AND METHODSWe have evaluated patients treated with Daratumumab, recording: demographic data, previous number of lines of treatment, use in monotherapy or combination, date of initiation of treatment, response to it, date of suspension (if it occurred) and its cause, as well as total duration of the treatment (figure 1 and 2).RESULTSWe studied 12 patients, 6 men and 6 women, treated with Daratumumab between 2016 and 2018. The average age is 63.75 years (range between 57 and 72).On average, it was used in the 4th line of treatment, ranging between 2 cases in which it was the 2nd and 1 in which it was the 7th. In all patients, it was used in monotherapy.Currently, 3 out of the 12 patients are still being treated with Daratumumab and they are in remission (objectified by PET-CT in 1 patient with only 4 months of treatment). 2 other patients are in partial remission (with 23 and 4 completed months of treatment, respectively). It was necessary to suspend the drug in 8 patients, in 7 cases due to progression of the disease. The remaining patient suffered, in the 1st administration, an adverse reaction of type III that was refractory to the symptomatic treatment and to the decrease of the infusion rate, which forced to withdraw the drug.In 4 cases, the drug was discontinued and the result was “stable disease”, so it remained until progression was evidenced. The average maintenance of the drug until progression was 4 months, ranging between 2 and 6 months. In the remaining 3 patients the disease progressed, so the drug was discontinued.CONCLUSIONSThe MM treatment has to be individualized and adapted to the risks. The data obtained from our patients indicate that Daratumumab is a potentially valuable drug among the therapeutic arsenal against this pathology. However, we believe that the results would be much better if the treatment is started in earlier lines. DisclosuresRios:Amgen, Celgene, Janssen, and Takeda: Consultancy.