Daratumumab and dexamethasone is safe and effective for triple refractory myeloma patients: final results of the IFM 2014‐04 (Etoile du Nord) trial

Single agent daratumumab has shown clinical activity in relapsed, refractory multiple myeloma (RRMM). The Intergroupe Francophone du Myélome 2014‐04 trial was designed to further investigate daratumumab in combination with dexamethasone in triple RRMM patients. Patients received daratumumab infusions in combination with weekly dexamethasone until disease progression or unacceptable toxicity. Fifty‐seven patients were included in the trial and evaluable for response. The overall response rate and the clinical benefit rate were 33% (n = 19) and 48% (n = 27), respectively. Five (8·8%) patients achieved a very good partial response or better. The median time to response was 4 weeks. For responding patients, the median progression‐free survival was 6·6 months, compared to 3·7 months (3·0–5·5) for those with a minimal or stable disease. The median overall survival (OS) for all patients was 16·7 months (11·2–24·0). For responding patients, the median OS was 23·23 months, whereas that of patients with progressive disease was 2·97 months. The incidence of infusion‐related reactions was 37%; all cases were manageable and did not lead to dose reduction or permanent treatment discontinuation. These data demonstrate that treatment with daratumumab and dexamethasone results in a meaningful long‐term benefit with an acceptable safety profile for patients with triple RRMM.

[1]  K. Bowles,et al.  CD38-Driven Mitochondrial Trafficking Promotes Bioenergetic Plasticity in Multiple Myeloma. , 2019, Cancer research.

[2]  M. Dimopoulos,et al.  Results from a Phase II Study of Isatuximab As a Single Agent and in Combination with Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma , 2018, Blood.

[3]  C. Schmotzer,et al.  Interference of Therapeutic Monoclonal Antibodies With Routine Serum Protein Electrophoresis and Immunofixation in Patients With Myeloma: Frequency and Duration of Detection of Daratumumab and Elotuzumab , 2018, American journal of clinical pathology.

[4]  G. Hardiman,et al.  CD38-NAD+Axis Regulates Immunotherapeutic Anti-Tumor T Cell Response. , 2018, Cell metabolism.

[5]  J. Fay,et al.  Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma. , 2017, Blood.

[6]  Tetsuro Ito,et al.  Daratumumab monotherapy compared with historical control data in heavily pretreated and highly refractory patients with multiple myeloma: An adjusted treatment comparison , 2017, American journal of hematology.

[7]  Bie M. P. Verbist,et al.  Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma. , 2016, Blood.

[8]  S. Croockewit,et al.  Interference of daratumumab in monitoring multiple myeloma patients using serum immunofixation electrophoresis can be abrogated using the daratumumab IFE reflex assay (DIRA) , 2016, Clinical chemistry and laboratory medicine.

[9]  A. Jakubowiak,et al.  Daratumumab monotherapy in patients with treatment-refractory multiple myeloma (SIRIUS): an open-label, randomised, phase 2 trial , 2016, The Lancet.

[10]  S. Lonial,et al.  Clinical efficacy of daratumumab monotherapy in patients with heavily pretreated relapsed or refractory multiple myeloma. , 2015, Blood.

[11]  A. Palumbo,et al.  Targeting CD38 with Daratumumab Monotherapy in Multiple Myeloma. , 2015, The New England journal of medicine.

[12]  M. Dimopoulos,et al.  Treatment options for relapsed and refractory multiple myeloma. , 2015, Blood.

[13]  Yunxin Chen,et al.  Daratumumab and its potential in the treatment of multiple myeloma: overview of the preclinical and clinical development , 2015, Therapeutic advances in hematology.

[14]  Kurt Hornik,et al.  The Comprehensive R Archive Network , 2012 .

[15]  H. Goldschmidt,et al.  Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group study , 2012, Leukemia.

[16]  Kenneth C. Anderson,et al.  Daratumumab, a Novel Therapeutic Human CD38 Monoclonal Antibody, Induces Killing of Multiple Myeloma and Other Hematological Tumors , 2011, The Journal of Immunology.

[17]  B. Barlogie,et al.  International uniform response criteria for multiple myeloma , 2006, Leukemia.

[18]  R. Rabin,et al.  EQ-SD: a measure of health status from the EuroQol Group , 2001, Annals of medicine.

[19]  S. Kaasa,et al.  Development of an EORTC questionnaire module to be used in health‐related quality‐of‐life assessment for patients with multiple myeloma , 1999, British journal of haematology.

[20]  S. Jagannath,et al.  CRITERIA FOR EVALUATING DISEASE RESPONSE AND PROGRESSION IN PATIENTS WITH MULTIPLE MYELOMA TREATED BY HIGH‐DOSE THERAPY AND HAEMOPOIETIC STEM CELL TRANSPLANTATION , 1998, British journal of haematology.

[21]  D. Osoba,et al.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. , 1993, Journal of the National Cancer Institute.

[22]  H. Goldschmidt,et al.  Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group study , 2012, Leukemia.

[23]  P. Tooley,et al.  Food and drugs , 1971 .

[24]  O. Cope,et al.  Multiple myeloma. , 1948, The New England journal of medicine.