Xia C, Ribeiro M, Scott S, Lonial S
Department of Hematology and Medical Oncology, Atlanta VA Medical Center, Atlanta, Georgia, USA.
Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
Drugs Today (Barc). 2016 Oct;52(10):551-560. doi: 10.1358/dot.2016.52.10.2543308.
Daratumumab (Darzalex[TM]) is a human monoclonal antibody (MAb) that targets CD38; a surface protein highly expressed across multiple myeloma (MM) cells. Preclinical studies have shown daratumumab induces MM cell death through several mechanisms, including complement-dependent cytotoxicity (CDC) antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-dependent cellular phagocytosis (ADCP), apoptosis upon secondary crosslinking and immunomodulatory effects via a decrease in immune suppressive cells. Daratumumab has a favorable toxicity profile and encouraging clinical activity as a single agent and in combination with lenalidomide in heavily pretreated, relapsed patients in whom other novel agents (such as bortezomib, thalidomide and lenalidomide) and stem cell transplant have already failed. Given the encouraging efficacy and acceptable safety profile, daratumumab has emerged as a novel treatment option for MM both as a monotherapy and in combination with conventional and novel anti-MM agents. This review will focus on preclinical pharmacology, pharmacokinetics, safety and clinical development of daratumumab in MM.
达雷妥尤单抗(兆珂[TM])是一种靶向CD38的人源单克隆抗体(MAb);CD38是一种在多发性骨髓瘤(MM)细胞中高度表达的表面蛋白。临床前研究表明,达雷妥尤单抗通过多种机制诱导MM细胞死亡,包括补体依赖性细胞毒性(CDC)、抗体依赖性细胞介导的细胞毒性(ADCC)、抗体依赖性细胞吞噬作用(ADCP)、二次交联后的凋亡以及通过减少免疫抑制细胞产生的免疫调节作用。达雷妥尤单抗具有良好的毒性特征,作为单一药物以及与来那度胺联合用于经过大量预处理的复发患者时,展现出令人鼓舞的临床活性,这些患者中其他新型药物(如硼替佐米、沙利度胺和来那度胺)及干细胞移植均已失败。鉴于其令人鼓舞的疗效和可接受的安全性,达雷妥尤单抗已成为MM的一种新型治疗选择,可作为单药治疗,也可与传统及新型抗MM药物联合使用。本综述将聚焦于达雷妥尤单抗在MM中的临床前药理学、药代动力学、安全性及临床开发情况。