An evaluation of subcutaneous daratumumab for the treatment of multiple myeloma

Expert Rev Hematol. 2020 Aug;13(8):795-802. doi: 10.1080/17474086.2020.1795829. Epub 2020 Sep 20.

Abstract

Introduction: A subcutaneous formulation of daratumumab, a human immunoglobulin G1 kappa monoclonal antibody targeting CD38, recently achieved FDA approval for both newly diagnosed and relapsed refractory multiple myeloma amid promises to decrease infusion times and rates of infusion reactions in myeloma patients.

Areas covered: In this article the biology behind subcutaneous administration of oncologic antibody therapies is reviewed and the subcutaneous formulation of daratumumab is covered in depth. The most recent results from the PAVO, COLUMBA, and PLEIADES clinical trials evaluating subcutaneous daratumumab as a single agent, and in combination, in both newly diagnosed, and relapsed and refractory myeloma patients are summarized. The efficacy, safety, and PK data from these trials are reviewed, and the potential of the subcutaneous formulation to improve quality of life in myeloma patients and decrease healthcare resource use is discussed.

Expert opinion: Subcutaneous daratumumab is non-inferior to conventional intravenous daratumumab with lower risk of infusion-related reactions and decreased administration time. Based on these data, and the recent FDA and European Commission approvalsthe widespread use of the subcutaneous formulation for both conventional and investigational practice is supported.

Keywords: Daratumumab; multiple myeloma; refractory; relapsed; subcutaneous.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • ADP-ribosyl Cyclase 1 / antagonists & inhibitors
  • Administration, Intravenous
  • Antibodies, Monoclonal / administration & dosage*
  • Antineoplastic Agents, Immunological / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor
  • Clinical Trials as Topic
  • Humans
  • Injections, Subcutaneous
  • Membrane Glycoproteins / antagonists & inhibitors
  • Molecular Targeted Therapy
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / etiology
  • Multiple Myeloma / mortality
  • Prognosis
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • Membrane Glycoproteins
  • daratumumab
  • CD38 protein, human
  • ADP-ribosyl Cyclase 1