Cook Gordon, Corso Alessandro, Streetly Matthew, Mendeleeva Larisa P, Ptushkin Vadim V, Chan Edmond, Ukropec Jon, Iraqi Wafae, Al-Akabawi Assem, Pei Huiling, Gaudig Maren, Petrucci Maria Teresa, Alegre Adrian, Mateos Maria-Victoria
Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK.
Division of Hematology, Ospedale di Legnano, Milan, Italy.
Oncol Ther. 2021 Jun;9(1):139-151. doi: 10.1007/s40487-020-00137-x. Epub 2021 Feb 25.
Daratumumab is a human IgGκ monoclonal antibody targeting CD38. Despite the demonstrated benefit of daratumumab in multiple myeloma, not all patients have access to commercially available daratumumab. Here we report a pooled analysis of patients from the UK, Spain, Italy, and Russia enrolled in an open-label, early access treatment protocol (EAP) that provided daratumumab (16 mg/kg) monotherapy to patients with heavily pre-treated relapsed or refractory multiple myeloma (RRMM).
Intravenous daratumumab 16 mg/kg was administered to patients who had received ≥ 3 prior lines of therapy, including a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD), or who were double refractory to both a PI and an IMiD. Safety and patient-reported outcomes data were collected.
A total of 293 patients received ≥ 1 dose of daratumumab. The median duration of daratumumab exposure was 4.2 (range 0.03-24.1) months, with a median number of 13 (range 1-37) infusions. The overall response rate was 33.1%, and the median progression-free survival was 4.63 months. Grade 3/4 treatment-emergent adverse events occurred in 60.1% of patients, of which the most common were thrombocytopenia (18.8%), anemia (11.9%), and neutropenia (11.6%). The most common serious adverse events were pneumonia (4.4%) and pyrexia (4.1%). Infusion-related reactions occurred in 45.1% of patients. The median change from baseline in all domains of patient-reported outcome instruments (European Quality of Life Five Dimensions Questionnaire [EQ-5D-5L], European Organisation for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire [QLQ-C30], and EORTC Multiple Myeloma Module [QLQ-MY20]) was generally 0 or close to 0.
These EAP results are consistent with those from previous trials of daratumumab monotherapy and confirm its safety in patients from Europe and Russia with heavily pre-treated RRMM.
ClinicalTrials.gov identifier, NCT02477891.
达雷妥尤单抗是一种靶向CD38的人IgGκ单克隆抗体。尽管已证明达雷妥尤单抗在多发性骨髓瘤治疗中具有显著疗效,但并非所有患者都能获得市售的达雷妥尤单抗。在此,我们报告了一项对来自英国、西班牙、意大利和俄罗斯的患者进行的汇总分析,这些患者参加了一项开放标签的早期获取治疗方案(EAP),该方案为经过大量前期治疗的复发或难治性多发性骨髓瘤(RRMM)患者提供达雷妥尤单抗(16mg/kg)单药治疗。
对接受过≥3线前期治疗(包括蛋白酶体抑制剂(PI)和免疫调节剂(IMiD))或对PI和IMiD均双重耐药的患者静脉注射16mg/kg达雷妥尤单抗。收集安全性和患者报告结局数据。
共有293例患者接受了≥1剂达雷妥尤单抗。达雷妥尤单抗暴露的中位持续时间为4.2(范围0.03 - 24.1)个月,中位输注次数为13次(范围1 - 37次)。总缓解率为33.1%,中位无进展生存期为4.63个月。60.1%的患者发生3/4级治疗中出现的不良事件,其中最常见的是血小板减少(18.8%)、贫血(11.9%)和中性粒细胞减少(11.6%)。最常见的严重不良事件是肺炎(4.4%)和发热(4.1%)。45.1%的患者发生输注相关反应。患者报告结局工具(欧洲生活质量五维度问卷[EQ - 5D - 5L]、欧洲癌症研究与治疗组织[EORTC]生活质量问卷[QLQ - C30]和EORTC多发性骨髓瘤模块[QLQ - MY20])所有领域从基线的中位变化通常为0或接近0。
这些EAP结果与先前达雷妥尤单抗单药治疗试验的结果一致,并证实了其在欧洲和俄罗斯经过大量前期治疗的RRMM患者中的安全性。
ClinicalTrials.gov标识符,NCT02477891。