Daratumumab Combination Therapy for Relapsed or Refractory Multiple Myeloma
Adding daratumumab to the combination of pomalidomide and dexamethasone induced “rapid, deep, and durable responses” in heavily pretreated patients with multiple myeloma, according to Ajai Chari, MD, Associate Professor of Medicine for Hematology and Medical Oncology at Tisch Cancer Institute, Mount Sinai School of Medicine, New York, and colleagues.
This open-label, nonrandomized, multicenter phase Ib study, which was published in Blood, tested the monoclonal antibody daratumumab in combination with pomalidomide and dexamethasone in 103 patients with relapsed or refractory multiple myeloma.
Researchers reported the safety profile of the triple-agent therapy was similar to that of the combination of pomalidomide and dexamethasone alone, except for daratumumab-specific infusion reactions and a higher incidence of neutropenia (76% grade 3 or greater, without an increase in infection rate). Additional grade 3 or higher adverse events included anemia and leukopenia.
The use of anti-CD38 antibodies and immunomodulatory drugs has the potential to induce significant neutropenia, as was reported in this trial in approximately two-thirds of patients. Therefore, the investigators recommend that clinicians would need to begin this triple combination treatment with low doses and monitor patients closely.
An overall response rate of 60% with the triplet, which was generally consistent across subgroups, was reported.