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皮下注射达雷妥尤单抗治疗复发/难治性多发性骨髓瘤的日本患者。

Subcutaneous delivery of daratumumab in Japanese patients with relapsed/refractory multiple myeloma.

机构信息

Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.

Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan.

出版信息

Int J Hematol. 2021 Jan;113(1):112-121. doi: 10.1007/s12185-020-02985-9. Epub 2020 Sep 11.

Abstract

Subcutaneous daratumumab (DARA SC; daratumumab co-formulated with recombinant human hyaluronidase PH20) is administered in ~ 5 min and demonstrates safety and efficacy comparable to intravenous daratumumab, with low infusion-related reaction (IRR) rates in global populations. This open-label, multicenter, phase 1 study is the first evaluation of DARA SC in Japanese patients. Eligible patients had relapsed/refractory multiple myeloma (RRMM; ≥ 2 prior lines of therapy including a proteasome inhibitor and immunomodulatory drug). Patients (N = 6) received DARA SC 1,800 mg until progression (weekly for Cycles 1-2; every 2 weeks for Cycles 3-7; monthly for Cycles 7 + [28-day cycles]). The primary objective was to evaluate safety. Secondary objectives included efficacy and pharmacokinetics. Median time of administration was 3-4 min for all injections. No dose-limiting toxicity occurred, and no treatment-emergent adverse events were serious or led to discontinuation. No IRRs were observed; 4 (67%) patients had injection-site reactions (all grade 1). Overall response rate was 67%. Pharmacokinetics of DARA SC in Japanese patients were similar to findings from the global phase 1b PAVO study (NCT02519452). DARA SC at a flat dose of 1,800 mg was well tolerated in Japanese RRMM patients with comparable efficacy and pharmacokinetics to intravenous daratumumab. ClinicalTrials.gov identifier NCT03242889.

摘要

皮下注射达雷妥尤单抗(DARA SC;与重组人透明质酸酶 PH20 联合配制的达雷妥尤单抗)的给药时间约为 5 分钟,其安全性和疗效与静脉注射达雷妥尤单抗相当,且全球人群中输注相关反应(IRR)发生率较低。这项开放标签、多中心、I 期研究是 DARA SC 在日本患者中的首次评估。符合条件的患者患有复发/难治性多发性骨髓瘤(RRMM;包括蛋白酶体抑制剂和免疫调节剂在内的≥2 种既往治疗线)。患者(N=6)接受 1800mg DARA SC 治疗,直至疾病进展(第 1-2 周期每周一次;第 3-7 周期每 2 周一次;第 7 周期及以后(28 天周期)每月一次)。主要目标是评估安全性。次要目标包括疗效和药代动力学。所有注射的中位给药时间为 3-4 分钟。未发生剂量限制性毒性,无治疗出现的不良事件严重或导致停药。未观察到 IRR;4(67%)名患者出现注射部位反应(均为 1 级)。总缓解率为 67%。日本患者的 DARA SC 药代动力学与全球 I 期 b 期 PAVO 研究(NCT02519452)的结果相似。在日本 RRMM 患者中,以 1800mg 固定剂量使用 DARA SC 具有良好的耐受性,其疗效和药代动力学与静脉注射达雷妥尤单抗相当。临床试验.gov 标识符 NCT03242889。

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