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Article: 3-weekly daratumumab-lenalidomide/pomalidomide-dexamethasone is highly effective in relapsed and refractory multiple myeloma

Title3-weekly daratumumab-lenalidomide/pomalidomide-dexamethasone is highly effective in relapsed and refractory multiple myeloma
Authors
Keywords3-weekly daratumumab regimen
Dara-IMID-dex regimen
Relapsed or refractory multiple myeloma
Efficacy
Rapid deep responses
MRD-ve CR
PET-ve CR‌
Affordability‌
Issue Date2021
PublisherTaylor & Francis. The Journal's web site is located at http://www.tandfonline.com/loi/yhem20
Citation
Hematology, 2021, v. 26 n. 1, p. 652-655 How to Cite?
AbstractObjectives: Myeloma relapse remains challenging. Daratumumab (dara) with immunomodulatory agents (IMiD) and dexamethasone (dex) was proven highly effective in relapsed or refractory multiple myeloma (RRMM) in randomized controlled trials. The recommended schedule of dara is weekly for eight doses, followed by 2-weekly for eight doses, and then every 4-weekly thereafter. However, the cost of daratumumab is daunting, precluding widespread and prolonged use in some countries. In this study, we aimed to evaluate the efficacy of using a 3-weekly daratumumab regimen in RRMM. Methods: Thirteen RRMM patients were treated with dara-IMiD-dex till maximal response, followed by single-agent IMiD maintenance until disease progression. Dara (every 6 weekly) would be added upon significant biochemical disease progression. Results: After a median of four daratumumab infusions (range: 3–10), the best responses included complete response (CR) in seven patients (53.8%), very good partial response (VGPR) in four patients (30.8%), and partial response (PR) in two patients (15.4%). The median time to VGPR was four weeks. At 10 months, the overall survival was 90%, and progression-free survival was 54.7%. Two of three patients tested achieved MRD-ve CR. Another patient, who had PET-CT reassessment, showed PET-ve CR. Discussion: Despite less frequent daratumumab use, we reported rapid responses with a median time to VGPR of only four weeks, and a response rate of 100% including CR rate of 54%. Despite less frequent daratumumab use, grade ¾ neutropenia remained common with a frequency comparable to that observed in Pollux. Conclusion: This 3-weekly dara-IMiD-dex regimen preserves a high efficacy with rapid, deep responses including MRD-ve and PET-ve CR, hence a cost-effective regimen.
Persistent Identifierhttp://hdl.handle.net/10722/308304
ISSN
2023 Impact Factor: 2.0
2023 SCImago Journal Rankings: 0.543
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChim, CS-
dc.contributor.authorKumar, S-
dc.contributor.authorWong, VKC-
dc.contributor.authorNgai, C-
dc.contributor.authorKwong, YL-
dc.date.accessioned2021-11-12T13:45:23Z-
dc.date.available2021-11-12T13:45:23Z-
dc.date.issued2021-
dc.identifier.citationHematology, 2021, v. 26 n. 1, p. 652-655-
dc.identifier.issn1024-5332-
dc.identifier.urihttp://hdl.handle.net/10722/308304-
dc.description.abstractObjectives: Myeloma relapse remains challenging. Daratumumab (dara) with immunomodulatory agents (IMiD) and dexamethasone (dex) was proven highly effective in relapsed or refractory multiple myeloma (RRMM) in randomized controlled trials. The recommended schedule of dara is weekly for eight doses, followed by 2-weekly for eight doses, and then every 4-weekly thereafter. However, the cost of daratumumab is daunting, precluding widespread and prolonged use in some countries. In this study, we aimed to evaluate the efficacy of using a 3-weekly daratumumab regimen in RRMM. Methods: Thirteen RRMM patients were treated with dara-IMiD-dex till maximal response, followed by single-agent IMiD maintenance until disease progression. Dara (every 6 weekly) would be added upon significant biochemical disease progression. Results: After a median of four daratumumab infusions (range: 3–10), the best responses included complete response (CR) in seven patients (53.8%), very good partial response (VGPR) in four patients (30.8%), and partial response (PR) in two patients (15.4%). The median time to VGPR was four weeks. At 10 months, the overall survival was 90%, and progression-free survival was 54.7%. Two of three patients tested achieved MRD-ve CR. Another patient, who had PET-CT reassessment, showed PET-ve CR. Discussion: Despite less frequent daratumumab use, we reported rapid responses with a median time to VGPR of only four weeks, and a response rate of 100% including CR rate of 54%. Despite less frequent daratumumab use, grade ¾ neutropenia remained common with a frequency comparable to that observed in Pollux. Conclusion: This 3-weekly dara-IMiD-dex regimen preserves a high efficacy with rapid, deep responses including MRD-ve and PET-ve CR, hence a cost-effective regimen.-
dc.languageeng-
dc.publisherTaylor & Francis. The Journal's web site is located at http://www.tandfonline.com/loi/yhem20-
dc.relation.ispartofHematology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subject3-weekly daratumumab regimen-
dc.subjectDara-IMID-dex regimen-
dc.subjectRelapsed or refractory multiple myeloma-
dc.subjectEfficacy-
dc.subjectRapid deep responses-
dc.subjectMRD-ve CR-
dc.subjectPET-ve CR‌-
dc.subjectAffordability‌-
dc.title3-weekly daratumumab-lenalidomide/pomalidomide-dexamethasone is highly effective in relapsed and refractory multiple myeloma-
dc.typeArticle-
dc.identifier.emailChim, CS: jcschim@HKUCC-COM.hku.hk-
dc.identifier.emailKwong, YL: ylkwong@hkucc.hku.hk-
dc.identifier.authorityChim, CS=rp00408-
dc.identifier.authorityKwong, YL=rp00358-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1080/16078454.2021.1965737-
dc.identifier.pmid34474661-
dc.identifier.scopuseid_2-s2.0-85114305581-
dc.identifier.hkuros329969-
dc.identifier.volume26-
dc.identifier.issue1-
dc.identifier.spage652-
dc.identifier.epage655-
dc.identifier.isiWOS:000692248700001-
dc.publisher.placeUnited Kingdom-

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