The role of daratumumab in the treatment of patients with relapsed/refractory plasma cell myeloma

Abstract

Despite the significant progress achieved during last two decades, plasma cell myeloma (PCM) remains an incurable disease. The greatest challenge in clinical practice is the optimal treatment of the high-risk group of patients. Numerous clinical trials demonstrated that presence of high-risk cytogenetic aberrations, such as del17p, t(4;14), t(14;16) lub t(14;20), still negatively affects patients’ outcomes in the current era of modern anti-myeloma agents such as proteasome inhibitors (Pi) or immunomodulatory drugs (IMiD). Among other groups of patients with unfavorable prognosis are patients who are refractory to a PIs and IMiD and patients with relapsed disease who had received three or more prior lines of therapy. Improving treatment outcomes in these patients requires novel drugs with different mechanisms of action, which would be able to overcome resistance to standard therapy. In this context, daratumumab i elotuzumab — two novel monoclonal antibodies (MoAbs) directed against myeloma cell surface antigens are of great interest. Daratumumab, a first-in-class anti-CD38 MoAb, has shown significant clinical activity and acceptable toxicity profile in relapsed/refractory PCM, in monotherapy as well as in combination with PI or IMiD. In this review, we discuss the role of daratumumab in the treatment of PCM, with emphasis on the efficacy of this drug in the group of high-risk patients.