Onkológia 3/2018
Daratumumab v kombinovanej liečbe mnohopočetného myelómu
Daratumumab combination therapy for multiple myeloma Monoclonal antibodies are currently the most investigated therapeutic compounds in oncology and are an important new class of agents with unique mechanisms of action in the treatment of multiple myeloma (MM). Daratumumab is a CD38 monoclonal antibody that has demonstrated substantial acitivity and good tolerability in clinical trials. Daratumumab showed remarkable single-agent activity, but is also an attractive partner in combination regimens. Indeed, deep responses and prolonged progression-free survival can be achieved in relapsed/refractory MM patients when CD38 antibodies are combined with immunomodulatory agents or proteasome inhibitors. Infusionrelated reactions, which typically occur during the first infusion, are the most frequent adverse events. On the basis of these findings, daratumumab monotherapy was approved by the European Medical Agency in patients with relapsed and refractory multiple myeloma, whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy. In 2017 daratumumab was approved in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the patients who have received at least one prior therapy. Our review provides an overview of the mechanism of action and results from the daratumumab clinical trials conducted to date, as well as practical management considerations for the interference of CD38 antibodies with certain laboratory assays, which may complicate response evaluation and blood compatibility testing.
Keywords: multiple myeloma, daratumumab, combination therapies, monoclonal antibody
