Daratumumab‐Based Combinational Therapy as Second‐Line Treatment of Relapsed‐Refractory Multiple Myeloma: A Single‐Center Experience

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BACKGROUND: Daratumumab represents the first-in-class fully humanized monoclonal antibody that targets CD38 for the treatment of relapsed/refractory multiple myeloma (RRMM). Evidence from randomized controlled trials has shown daratumumab to be efficacious in the setting of second-line combinational therapy for pretreated multiple myeloma. However, real-world evidence that supports daratumumab use in daily clinical practice remains scarce. AIM: The primary objective of this study was to describe the real-world clinical and adverse effects observed in RRMM patients receiving daratumumab as second-line therapy. METHODS: This was an observational case series with a retrospective chart review of pretreated multiple myeloma patients who received daratumumab-based combinational therapy at an academic medical center. The primary end point was progression-free survival. Additional end points included overall response rates, adverse effects of daratumumab therapy, and subsequent treatment options following daratumumab. RESULTS: Seventeen patients were included. The overall response rate of daratumumab in our patients with RRMM was 13/17 (76.5%), and the median progression-free survival was 20 months when daratumumab was used in the second-line setting. Common adverse effects included neutropenia (52.9%), thrombocytopenia (64.7%), anemia (35.7%), and pneumonia (35.3%). On follow-up, 10 patients remained alive at the experimental cut-off date, with 2 patients kept on daratumumab-based combinational therapy; 5 patients were switched to carfilzomib-based therapy; and 3 received best supportive care. CONCLUSION: In our single-center experience with Taiwanese RRMM patients, daratumumab in combinational therapy showed promising efficacy, and modest tolerance in the second-line setting.

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