Results from a recent real-world analysis suggest possible benefits with early use of daratumumab-based triplet therapies in patients with relapsed/refractory (RR) multiple myeloma (MM). The study’s findings were reported in the journal Leukemia Research Reports.
Prior research had supported the efficacy and safety of daratumumab in combination therapy for MM in the first line setting for older patients and transplant-eligible younger patients. However, data regarding its use in combination therapy in patients with advanced disease have been limited, the study investigators explained in their report.
This retrospective study was a case series that included patients with RRMM who were receiving daratumumab as a component of triplet therapy in the real-world treatment setting. Patient, disease, and treatment characteristics, in addition to efficacy and safety outcomes, were evaluated to characterize the use of daratumumab in this patient population.
A total of 34 patients with RRMM were included in the analysis, and they had a median age of 73.2 years. Most patients (85.3%) had received 1 prior line of therapy, while 14.7% had received 2 or more prior lines of therapy.
Daratumumab was included in a triplet therapy with lenalidomide and dexamethasone in 88.3% of patients, and it was combined with bortezomib and dexamethasone in 11.7%. The overall response rate was 88% in the total study population, with complete response reported in 12% of patients. Very good partial response (VGPR) was reported in 44%, and partial response was seen in 32% of patients.
Median progression-free survival (PFS) and overall survival (OS) times had not been reached by a median follow-up time of 16 months. The 12-month PFS rate was 78%, and the 12-month OS rate was 86.5%. A univariate analysis suggested that PFS was associated with attainment of VGPR or better, receipt of only 1 prior line of therapy, and male gender. OS appeared to be associated with a lack of anemia at the beginning of the daratumumab-based triplet therapy, in addition to a response of VGPR or better. Multivariate analysis indicated that a response of VGPR or better was the only factor associated with longer PFS (hazard ratio, 0.037; 95% CI, 0.0001-0.988; P =.049).
Among hematological adverse events, neutropenia was reported in 44.0% of patients, with thrombocytopenia seen in 29.0%. Among the most common nonhematological adverse events, diarrhea was reported in 8.8%, and asthenia was reported in 8.2%. There was 1 grade 4 adverse event that occurred, which was gastrointestinal in nature.
The study investigators concluded that although this study cohort was small, they considered the results to compare favorably with other recent research, “further reinforcing the early use of daratumumab-based triplets for the treatment of RRMM patients.”
Fucci L, Gensini L, Coppetelli U, et al. Daratumumab triplet therapies in patients with relapsed or refractory multiple myeloma: a “real world” experience. Leuk Res Rep. 2022;17:100330. doi:10.1016/j.lrr.2022.100330