Anti-CD38 monoclonal antibody daratumumab enhances the overall response rate in patients with multiple myeloma

Abstract

Purpose: New medicines employed in recent years have resulted in significant increases in survival rates for Multiple Myeloma (MM). Daratumumab, a monoclonal antibody against CD38, is utilized in both first-line myeloma treatment and relapsed/refractory illness. Our study aims to assess the clinical features, response to treatment and factors influencing response to treatment in patients who received daratumumab monotherapy or combination therapy at our center. Materials and methods: In the Pamukkale University Faculty of Medicine Hematology clinic between June 2022 and June 2023, 21 patients who were treated with daratumumab after receiving a multiple myeloma diagnosis were included. Demographic features of the patients, disease stage, prior therapies, characteristics of daratumumab treatment, and response rates to treatments were retrospectively analyzed. Results: The patients median age was 65±9.7 years (42-80), with a female/male ratio of 11/10. Treatment with daratumumab: 61.9% was used after two lines of therapy, 23.8% was used in first-line therapy, and 14.28% was used in second-line therapy. The average number of cycles was 4.05±5.06. Of the patients treated with daratumumab, 4.76% were treated as a single agent; 61.9% were treated in combination with immunomodulatory medications, cyclophosphamide and/or melphalan; and 33.4% were treated in conjunction with chemotherapy. When the response to treatment was evaluated, 38.1% of the patients passed away, 38.1% had a very good partial response (VGPR) or better, and 23.8% had a partial response (PR). 42.9% of patients who received daratumumab along with chemotherapy died. With daratumumab-containing regimens, overall response rates increased significantly as the number of cycles increased (ORR) (p=0.026). Conclusion: When daratumumab-containing protocols are used in the treatment of multiple myeloma, it has been observed that overall response rates improve and treatment success increases in direct proportion to the number of cures.