Daratumumab, Bortezomib, and Dexamethasone for Multiple Myeloma

• Published in: The New England journal of medicine Vol. 375; no. 8; pp. 754 - 766
• Main Authors: Palumbo, Antonio, Chanan-Khan, Asher, Weisel, Katja, Nooka, Ajay K, Masszi, Tamas, Beksac, Meral, Spicka, Ivan, Hungria, Vania, Munder, Markus, Mateos, Maria V, Mark, Tomer M, Qi, Ming, Schecter, Jordan, Amin, Himal, Qin, Xiang, Deraedt, William, Ahmadi, Tahamtan, Spencer, Andrew, Sonneveld, Pieter
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 25.08.2016
• Subjects: ADP-ribosyl Cyclase 1 - antagonists & inhibitors; Adult; Aged; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Body weight; Bortezomib; Bortezomib - administration & dosage; Bortezomib - adverse effects; CD38 antigen; Cytotoxicity; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Disease-Free Survival; Drug Resistance, Neoplasm; Drug therapy; Female; Humans; Immunotherapy; Infusions, Intravenous; Inhibitor drugs; Male; Middle Aged; Monoclonal antibodies; Multiple myeloma; Multiple Myeloma - drug therapy; Neutropenia; Patients; Recurrence; Steroids; Survival; Thrombocytopenia
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1606038

In a study involving patients with refractory multiple myeloma, the anti-CD38 antibody daratumumab in combination with bortezomib and dexamethasone resulted in longer progression-free survival and a higher rate of response than bortezomib and dexamethasone alone. Multiple myeloma is associated with organ dysfunction, including bone lesions, anemia, renal insufficiency, and hypercalcemia. 1 , 2 Proteasome inhibitors (e.g., bortezomib) in combination with glucocorticoids are standard regimens for relapsed or relapsed and refractory multiple myeloma 3 (definitions of these terms are provided in the Supplementary Appendix, available with the full text of this article at NEJM.org) and have contributed considerably to patient survival. 4 Nevertheless, almost all patients will have a relapse. Daratumumab is a human IgGκ monoclonal antibody that targets CD38, which is highly expressed on myeloma cells and other hematopoietic cell types. 5 , 6 Daratumumab has direct and indirect antitumor activity and diverse . . .