Daratumumab-containing regimens safe, effective against multiple myeloma

Adding daratumumab to backbone treatments against multiple myeloma (MM) yields high clinical efficacy and has an acceptable toxicity profile, a recent study has found. Such regimens are good treatment options for newly diagnosed (ND) and relapsed/refractory (RR) MM.

Drawing from the online databases of Medline, Embase, Web of Science, CENTRAL, and Scopus, the researchers retrieved 12 eligible randomized controlled trials looking at outcomes of a daratumumab-containing regimen in MM patients.

In patients with NDMM, treatment with daratumumab regimens led to a significant suppression of death or progression (hazard ratio [HR], 0.47, 95 percent confidence interval [CI], 0.39–0.57). Such risk was likewise lowered in standard-risk MM (HR, 0.43, 95 percent CI, 0.35–0.53) but not in patients with high cytogenetic risk.

Similarly, RRMM patients saw significant benefit when treated with daratumumab-containing regimens, with the risk of death or progression reduced by half (HR, 0.50, 95 percent CI, 0.37–0.67). This remained true in both standard-risk (HR, 0.38, 95 percent CI, 0.29–0.50) and high cytogenetic-risk (HR, 0.52, 95 percent CI, 0.35–0.76) patients.

In terms of safety, daratumumab showed acceptable toxicity profiles. In NDMM patients, daratumumab treatment led to an excess burden of lymphopaenia and neutropaenia, along with lower rates of peripheral neuropathy.

In RRMM, daratumumab use was associated with grade 3–4 thrombocytopaenia and lymphopaenia, as well as all grades of neutropaenia. No between-arm difference was reported for other haematological toxicities and hypertension.