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Review
. 2024 Oct 11;6(4):53-66.
doi: 10.46989/001c.124362. eCollection 2024.

Daratumumab-Based Therapeutic Approaches and Clinical Outcomes in Multiple Myeloma and other Plasma Cell Dyscrasias: Insights from a Nationwide Real-World Chart Review Study

Allison C Y Tso  1 , Wee Joo Chng  2 , Yeow Tee Goh  3 , Melissa G Ooi  2 , Yunxin Chen  3 , Chandramouli Nagarajan  3 , Daryl Tan  4 , Sanchalika Acharyya  5 , Kiat Hoe Ong  1
Affiliations
Review

Daratumumab-Based Therapeutic Approaches and Clinical Outcomes in Multiple Myeloma and other Plasma Cell Dyscrasias: Insights from a Nationwide Real-World Chart Review Study

Allison C Y Tso et al. Clin Hematol Int. .

Abstract

Singapore leads Southeast Asia in the routine use of daratumumab for multiple myeloma and other plasma cell dyscrasias. This retrospective review analyzed 112 patients who received daratumumab between 2012 and 2020. Tolerability, and efficacy based on prior lines (PL) of therapy, cytogenetic risk group, and the presence of renal impairment were presented. Infusion-related reactions occurred in 26.8% of patients. Grades 1 and 2 hematological and non-hematological adverse events were observed in 14.3% and 33.9% of patients, respectively. After a median follow-up of 16.9 months, there was no significant difference in overall response rates (ORR) (86% versus 76.3%, p = 0.082) or depth of response (≥ complete response (CR), 35.1% versus 28.9%, p = 0.469) between myeloma patients with and without renal dysfunction. Newly diagnosed and relapsed/refractory patients had an ORR of 92% and 76.3%, and a ≥ VGPR (very good partial response) rate of 80% and 55.3%, respectively. Median progression-free survival (PFS) was better for patients with 0/1 PL compared to ≥ 2 PLs (19.8 versus 6.2 months, p < 0.001), with a deeper response (≥ CR, 38.5% versus 16.7%, p = 0.033). Forty-six and a half percentage of patients had high-risk FISH abnormalities, and those with 0/1 PL had a significantly better ORR than those with ≥ 2 PLs (83.3% vsersus 47.1%, p = 0.022), achieving an ORR similar to that of the general cohort (80.2%, p = 0.905). In conclusion, positioning daratumumab in earlier lines of therapy leads to better outcomes and may mitigate the impact of high-risk FISH abnormalities.

Keywords: Asian; daratumumab; multiple myeloma; plasma cell dyscrasia; real-world.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Figure 1.
Figure 1.. Kaplan-Meier survival analysis for all myeloma patients
Figure 2.
Figure 2.. Kaplan-Meier survival analysis for all myeloma patients by subgroups of number of prior lines of therapy
Figure 3.
Figure 3.. Kaplan-Meier survival analysis for all myeloma patients by subgroups of cytogenetic risk
Figure 4.
Figure 4.. Kaplan-Meier survival analysis for all myeloma patients by subgroups of cytogenetic risk and number of prior lines of therapy
Figure 5.
Figure 5.. Response rates according to the number of high-risk FISH abnormalities
Figure 6.
Figure 6.. Response according to renal impairment status
See this image and copyright information in PMC

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