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达雷妥尤单抗难治性多发性骨髓瘤患者接受达雷妥尤单抗为基础的再治疗(D2)的临床疗效。

Clinical efficacy of retreatment of daratumumab-based therapy (D2) in daratumumab-refractory multiple myeloma.

机构信息

Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Westwood, Kansas, USA.

US Myeloma Innovations Research Collaborative (USMIRC), Westwood, Kansas, USA.

出版信息

Eur J Haematol. 2023 Jun;110(6):626-632. doi: 10.1111/ejh.13942. Epub 2023 Feb 21.

Abstract

Daratumumab demonstrates activity as a single agent and in combination with either immunomodulatory agents (IMiDs) or proteasome inhibitors (PIs) in relapsed refractory multiple myeloma (RRMM). However, little is known about the benefit of daratumumab retreatment in daratumumab-refractory MM. This study aimed to analyze the clinical efficacy of daratumumab-based retreatment (D2) in patients who are daratumumab refractory MM. Retrospectively, we identified 43 RRMM patients from a single-center database review. The median age was 65 years, 42% patients had high-risk cytogenetics, and 23% had an extramedullary disease, while the median time between D2 and prior daratumumab was 1 (0.25-39) month. All D2 patients received combination therapy with either pomalidomide, carfilzomib, bortezomib, or lenalidomide. The response rate, median progression-free, and overall survival were 49%, 7.97 and 32.6 months, respectively. Our study raises the possibility of re-utilizing daratumumab in combination with different classes of anti-myeloma drugs to generate responses in RRMM patients who are daratumumab-refractory.

摘要

达雷妥尤单抗单药治疗以及与免疫调节剂 (IMiDs) 或蛋白酶体抑制剂 (PIs) 联合治疗在复发/难治性多发性骨髓瘤 (RRMM) 中均显示出疗效。然而,对于达雷妥尤单抗耐药的 MM 患者中达雷妥尤单抗再次治疗的获益知之甚少。本研究旨在分析达雷妥尤单抗再次治疗(D2)在达雷妥尤单抗耐药 MM 患者中的临床疗效。我们通过对单中心数据库的回顾性分析,确定了 43 例 RRMM 患者。中位年龄为 65 岁,42%的患者具有高危细胞遗传学特征,23%的患者有髓外疾病,而 D2 与之前达雷妥尤单抗之间的中位时间为 1(0.25-39)个月。所有 D2 患者均接受泊马度胺、卡非佐米、硼替佐米或来那度胺联合治疗。其缓解率、中位无进展生存期和总生存期分别为 49%、7.97 和 32.6 个月。我们的研究提出了在 RRMM 患者中再次使用达雷妥尤单抗联合不同类别的抗骨髓瘤药物产生应答的可能性,这些患者对达雷妥尤单抗耐药。

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