Patients who have been diagnosed with refractory multiple myeloma or a relapsed condition have seen to experience PFS or progression-free survival upon getting treated with Carfilzomib, Dexamethasone and Daratumumab compared to receiving the first two alone- claimed in the study results in The Lancet.
While it is true that novel agents have the capability of improving the survival rate for patients with multiple myeloma, the tendency of an inevitable relapse is seen in most cases afterwards. Patients even develop resistance to the most common first-line treatments conducted by Lenalidomide and Bortezomib. Not only that, but these forms of therapies can lead to unbearable toxicity in patients that may result in temporary or permanent suspension of treatment. The need for better treatment to treat relapsed and refractory diseases is certain.
The Study
Therefore, a clinical trial was conducted where a total of 466 patients have randomly been assigned KdD or Kd treatment in the 2:1 ratio, with the primary endpoint of PFS. Carfilzomib was assigned at 56 mg/m2 two times a week and Dexamethasone was administered weekly at a dosage of 40mg but 20mg for patients who were above 75 years. They were also given Daratumumab intravenously on days 1 and 2 at 8mg/kg, which later increased to 16mg/kg on a weekly basis. Note that both the groups consisted of patients who were diagnosed with Lenalidomide or Bortezomib refractory conditions.
Conclusion
After a median follow-up of about 17 months, the Kd group developed a median PFS while the KdD group did not. The overall response was recorded in 84% of patients from the KdD group compared to that of 75% of patients in the Kd group. Also, promising partial response was achieved by 69% of patients, and 29% had a completely positive response. 21% of the total number of patients had to discontinue Carfilzomib because they developed severely intolerable effects. Thus, the death risk was seen to have been reduced by 37% compared with Kd for patients who suffered from relapsed or refractory multiple myeloma.
FAQ's About Daratumumab
How is Daratumumab used?
Daratumumab is indicated in order to treat patients with multiple myeloma who have taken at least three prior lines of therapy; or along with lenalidomide and dexamethasone, or bortezomib and dexamethasone, in such patients who have taken at least one prior therapy.
What is the mechanism of action?
The cells of Multiple myeloma overexpress the CD38 protein. Therefore, investigators have designed daratumumab to specifically target and bind to a protein named CD38. This drug binds to the cells of cancer, and with the help of multiple pathways, the cells of cancer are killed once the binding occurs.
How is Daratumumab given (administered)? Daratumumab comes in order to be given by intravenous infusion.
How are patients monitored?
Patients need to be premedicated through antipyretics, antihistamines, and corticosteroids and should be monitored while on the entire infusion. In order to reduce the probability of delayed infusion reactions, all patients are administered oral corticosteroids the 1'st and 2'nd day following all infusions. Also, patients are administered an antiviral drug in order to prevent herpes zoster reactivation.
What are the most common side effects of treatment with Daratumumab?
- Fatigue
- Nausea
- Back pain
- Pyrexia
- Cough
- Infusion reactions
- Upper respiratory tract infection
What are certain less common but serious side effects of Daratumumab?
- Pneumonia
- Pyrexia
- General physical health deterioration
This is basically not an entire list of side effects. Certain patients may have other side effects, not listed here. Patients are apprised to discuss with their healthcare provider about other less common daratumumab side effects, some of which could be serious.
When should patients report their doctor?
With the use of daratumumab, infusion reactions are common and could be severe. Report your healthcare professional promptly in case you get any of the following symptoms:
- Cough
- Wheezing
- Throat tightness
- Headache
- Rash or hives
- Itching
- Nausea
- Vomiting
- Chills
- Shortness of breath
- Trouble breathing
- Dizziness
- Runny or stuffy nose
- Lightheadedness
Daratumumab may be responsible for causing interference with the cross-matching and RBC antibody screening. Inform all of your doctors that you are being treated with Daratumumab prior to receiving blood transfusions.
NOTE: The piece of information mentioned about "How can the inclusion of Daratumumab change the effectiveness of Multiple Myeloma medication?" in this article is just for informational purposes and is not served as a substitute for medical treatment, consultation, diagnosis of an experienced or qualified healthcare practitioner.
