Galusic Davor, Krecak Ivan, Blaslov Viktor, Krstulovic Opara Andela, Valkovic Toni, Basic Kinda Sandra
Division of Hematology, University Hospital of Split, 21000 Split, Croatia.
School of Medicine, University of Split, 21000 Split, Croatia.
Biomedicines. 2025 Jan 15;13(1):207. doi: 10.3390/biomedicines13010207.
Multiple myeloma (MM) is a hematologic disease characterized by the clonal expansion of malignant plasma cells that accumulate in the bone marrow, leading to osteolytic bone disease, hypercalcemia, anemia, and renal dysfunction. Daratumumab was the first monoclonal anti-CD38 antibody approved for the treatment of MM, initially in relapse/refractory settings and, more recently, for newly diagnosed patients. Increased first-line usage of daratumumab will also substantially change treatment approaches for patients with relapsed/refractory disease. Due to the cost and availability of bispecific T cell redirecting antibodies (BsAbs) and chimeric antigen receptor T cell therapy (CAR-T) in real-life settings in many countries, retreatment with daratumumab in subsequent lines of therapy might be a reasonable choice. Data regarding efficacy and optimal combinations of daratumumab retreatment are lacking, and here we provide a short literature review of available data. We identified only a small number of articles based on retrospective analysis of medical records in real-life settings. A strong consistency in results regarding response rates and treatment duration was noticed among mainly heavily pre-treated MM patients, with approximately half of patients achieving at least partial remission (PR) after retreatment with daratumumab-based protocol. The duration of treatment and time to the next treatment for retreatment episodes were considerable and consistent with clinical expectations for later lines of therapy. The analysis of data in this literature review indicates that daratumumab retreatment may provide meaningful clinical benefit to some patients with relapsed/refractory MM despite having prior exposure. However, further research is needed to identify clinical and biological parameters that may predict favorable responses to daratumumab retreatment.
多发性骨髓瘤（MM）是一种血液系统疾病，其特征为恶性浆细胞在骨髓中克隆性增殖，导致溶骨性骨病、高钙血症、贫血和肾功能不全。达雷妥尤单抗是首个被批准用于治疗MM的单克隆抗CD38抗体，最初用于复发/难治性患者，最近也用于新诊断患者。达雷妥尤单抗一线使用的增加也将显著改变复发/难治性疾病患者的治疗方法。由于在许多国家的现实环境中双特异性T细胞重定向抗体（BsAbs）和嵌合抗原受体T细胞疗法（CAR-T）的成本和可及性，在后续治疗线中使用达雷妥尤单抗进行再治疗可能是一个合理的选择。目前缺乏关于达雷妥尤单抗再治疗的疗效和最佳联合方案的数据，在此我们对现有数据进行简短的文献综述。我们仅通过对现实环境中医疗记录的回顾性分析确定了少数文章。在主要经过大量预处理的MM患者中，观察到缓解率和治疗持续时间的结果具有很强的一致性，约一半的患者在接受基于达雷妥尤单抗的方案再治疗后至少达到部分缓解（PR）。再治疗疗程的治疗持续时间和至下次治疗的时间相当可观，且与后续治疗线的临床预期一致。本综述中的数据分析表明，尽管之前已经使用过，但达雷妥尤单抗再治疗可能为一些复发/难治性MM患者提供有意义的临床益处。然而，需要进一步研究以确定可能预测对达雷妥尤单抗再治疗有良好反应的临床和生物学参数。
