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.

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Introduction: Daratumumab is an anti-CD38 monoclonal antibody used in the treatment of myeloma and other related disorders. To mitigate the risk of infusion related reactions with IV Daratumumab the product monograph suggested a slow administration schedule that extends over several hours. This leads to a significant burden for the outpatients' treatment administration units and indirect costs to the patients such as time toxicity.

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Daratumumab or Active Monitoring for High-Risk Smoldering Multiple Myeloma.

N Engl J Med

December 2024

From Alexandra General Hospital, National and Kapodistrian University of Athens, Athens (M.A.D.); Levine Cancer Institute, Atrium Health Wake Forest University School of Medicine, Charlotte, NC (P.M.V.); Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, Oslo (F.S.); Tel-Aviv Sourasky (Ichilov) Medical Center and Tel Aviv University, Tel Aviv, Israel (Y.C.C.); Clínica Medica São Germano, São Paulo (V.H.); Cross Cancer Institute, University of Alberta, Edmonton, Canada (I. Sandhu); Kent and Canterbury Hospital, Canterbury, United Kingdom (J.L.); Perth Blood Institute, Murdoch University, Perth, WA, Australia (R.I.B.); Japanese Red Cross Medical Center, Tokyo (K.S.); Ogaki Municipal Hospital, Ogaki City, Japan (H.K.); Albert Schweitzer Hospital, Dordrecht, the Netherlands (M.-D.L.); Ankara University, Ankara, Turkey (M.B.); Washington University School of Medicine, St. Louis (K.S.-G.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Barcelona (A.O.); South Pest Central Hospital, National Institute for Hematology and Infectious Diseases, Budapest, Hungary (G.M.); Hospital Alemán, Buenos Aires (G.G.); Jessa Hospital, Hasselt, Belgium (K.T.); Charles University and General Hospital, Prague, Czech Republic (I. Spicka); Rigshospitalet, University of Copenhagen, Copenhagen (A.K.M.); SSD Clinical Trials in Oncol-ematologia e Mieloma Multiplo, AOU Città della Salute e della Scienza di Torino, Turin, Italy (S.B.); Medical Unit Hematology, Karolinska University Hospital, Stockholm (K.U.); Institute of Hematology and Transfusion Medicine, Warsaw, Poland (B.P.); Knight Cancer Institute, Oregon Health and Science University, Portland (E.M.); University of Washington and Fred Hutchinson Cancer Center, Seattle (A.J.C.); University Hospital Hôtel-Dieu, Nantes, France (P.M.); University Hospital of Salamanca, IBSAL, and Cancer Research Center, IBMCC, Salamanca, Spain (M.-V.M.); GMMG Study Group at University Hospital Heidelberg, Internal Medicine V, Heidelberg, Germany (H.G.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Shanghai, China (L.S., L.L.); Janssen Scientific Affairs, Horsham, PA (A.C.); Janssen Research and Development, Raritan, NJ (E.G.K., R.M.D.); Janssen Research and Development, Beerse, Belgium (E.R.); Janssen Research and Development, Spring House, PA (R.C.); and Mayo Clinic, Rochester, MN (S.V.R.).

Background: Daratumumab, an anti-CD38 monoclonal antibody, has been approved for the treatment of multiple myeloma. Data are needed regarding the use of daratumumab for high-risk smoldering multiple myeloma, a precursor disease of active multiple myeloma for which no treatments have been approved.

Methods: In this phase 3 trial, we randomly assigned patients with high-risk smoldering multiple myeloma to receive either subcutaneous daratumumab monotherapy or active monitoring.

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Purpose: To provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab.

Patients And Methods: This was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study.

Results: Nine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean age 65.

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