Adding daratumumab to treatment with carfilzomib for patients with relapsed/refractory multiple myeloma (RRMM) may help prevent cardiovascular adverse events (CVAEs), according to research published in Cancers.
Despite the improvements in survival with carfilzomib treatment, patients still face risk of cardiac injury. The authors sought to determine whether adding daratumumab to therapy could protect the heart.
The study included 25 patients; 14 patients received daratumumab plus carfilzomib and dexamethasone (DaraKd) and 11 patients received carfilzomib and dexamethasone (Kd). Patients underwent cardiac ultrasound before the start of treatment and at the sixth treatment cycle.
All patients had similar baseline demographic characteristics. Patients in the Kd group had worse echocardiographic characteristics than patients in the DaraKd group when evaluated after treatment.
Left ventricular ejection fraction (P =.026) and left ventricular global longitudinal strain (P =.007) decreased in the Kd group but not in patients receiving DaraKd. The study authors saw deterioration in right ventricular systolic function only in the patients who received Kd.
Patients were followed for a median of 10 months. The researchers monitored for hypertension, heart failure, and acute coronary syndrome, which are common carfilzomib-related CVAEs.
A total of 5 of 11 patients in the Kd group had CVAEs, compared with 4 of 14 patients in the DaraKd group who experienced CVAEs.
Multiple studies have found deteriorating cardiac function with carfilzomib. This study, limited by its small sample size, found a potential cardioprotective effect of DaraKd. The authors surmised that daratumumab works by inhibiting CD38. The mechanisms by which this occurs warrant further inquiry.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Terpos E, Stamatelopoulos K, Makris N, et al. Daratumumab may attenuate cardiac dysfunction related to carfilzomib in patients with relapsed/refractory multiple myeloma: a prospective study. Cancers (Basel). 2021;13(20):5057. doi:10.3390/cancers13205057