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皮下注射达雷妥尤单抗治疗中国复发或难治性多发性骨髓瘤患者:一项开放标签、多中心、1期研究(MMY1010)。

Subcutaneous daratumumab in Chinese patients with relapsed or refractory multiple myeloma: an open-label, multicenter, phase 1 study (MMY1010).

作者信息

An Gang, Ge Zheng, Jing Hongmei, Liu Jing, Yang Guoping, Feng Ru, Xu Zhongyuan, Qi Ming, Wang Jianping, Song Juanjuan, Zhou Wei, Sun Binbin, Zhu Dian, Chen Xi, Cui Canchan, Qiu Lugui

机构信息

National Clinical Research Center for Hematological Disorders, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.

Department of Hematology, Zhongda Hospital Southeast University, Nanjing 210009, China.

出版信息

Blood Sci. 2024 May 31;6(3):e00193. doi: 10.1097/BS9.0000000000000193. eCollection 2024 Jul.

Abstract

Despite recent progress in multiple myeloma (MM) treatments, most patients will relapse and require additional treatment. Intravenous daratumumab, a human IgGκ monoclonal antibody targeting CD38, has shown good efficacy in the treatment of MM. A subcutaneous version of daratumumab was formulated to reduce the burden of intravenous infusions. We aimed to investigate the efficacy and safety of subcutaneous daratumumab in Chinese patients with relapsed/refractory MM based on the demonstrated noninferiority of subcutaneous daratumumab to intravenous daratumumab, with a shorter administration time and reduced infusion-related reaction rate in global studies. This phase 1, multicenter study (MMY1010; ClinicalTrials.gov Identifier: NCT04121260) evaluated subcutaneous daratumumab in Chinese patients with relapsed/refractory MM after 1 prior line (n = 1) or ≥2 prior lines (n = 20) of therapy, including a proteasome inhibitor and an immunomodulatory drug. Primary endpoints were pharmacokinetics and safety. Mean (standard deviation) maximum trough concentration of daratumumab was 826 (335) μg/mL, which was consistent with prior studies of subcutaneous daratumumab and intravenous daratumumab. Safety was consistent with safety profiles observed in other daratumumab studies, with no new safety concerns identified. Incidences of infusion-related reactions and injection-site reactions were low and consistent with other subcutaneous daratumumab studies. At a median follow-up of 7.5 months, the overall response rate was 57.1%, with a very good partial response or better rate of 38.1% and complete response or better rate of 19.0%. Our results demonstrate a favorable benefit/risk profile of subcutaneous daratumumab in Chinese patients with relapsed/refractory MM, potentially impacting clinical administration of daratumumab in this population.

摘要

尽管多发性骨髓瘤(MM)治疗最近取得了进展,但大多数患者仍会复发并需要额外治疗。静脉注射达雷妥尤单抗是一种靶向CD38的人IgGκ单克隆抗体,在MM治疗中显示出良好疗效。为减轻静脉输注负担,研发了皮下注射用达雷妥尤单抗。基于皮下注射用达雷妥尤单抗在全球研究中显示出不劣于静脉注射用达雷妥尤单抗,且给药时间更短、输注相关反应率更低,我们旨在研究皮下注射用达雷妥尤单抗在中国复发/难治性MM患者中的疗效和安全性。这项1期多中心研究(MMY1010;ClinicalTrials.gov标识符:NCT04121260)评估了皮下注射用达雷妥尤单抗在接受过1线(n = 1)或≥2线(n = 20)包括蛋白酶体抑制剂和免疫调节药物治疗的中国复发/难治性MM患者中的疗效,这些患者此前接受过1线治疗(n = 1)或≥2线治疗(n = 20)。主要终点是药代动力学和安全性。达雷妥尤单抗的平均(标准差)最大谷浓度为826(335)μg/mL,这与既往皮下注射用达雷妥尤单抗和静脉注射用达雷妥尤单抗的研究结果一致。安全性与其他达雷妥尤单抗研究中观察到的安全性特征一致,未发现新的安全问题。输注相关反应和注射部位反应的发生率较低,与其他皮下注射用达雷妥尤单抗研究一致。在中位随访7.5个月时,总缓解率为57.1%,非常好的部分缓解或更佳缓解率为38.1%,完全缓解或更佳缓解率为19.0%。我们的结果表明,皮下注射用达雷妥尤单抗在中国复发/难治性MM患者中具有良好的获益/风险特征,可能会影响该人群中达雷妥尤单抗的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5631/11146469/8c6bf1a5f65c/bs9-6-e00193-g001.jpg

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