Cited by 1,117Multiple Myeloma Research and TreatmentsMonoclonal and Polyclonal Antibodies ResearchChronic Lymphocytic Leukemia Research

Targeting CD38 with Daratumumab Monotherapy in Multiple Myeloma

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Lokhorst, Henk M., Plesner, Torben, Laubach, Jacob P., Nahi, Hareth, Gimsing, Peter, Hansson, Markus, Minnema, Monique C., Lassen, Ulrik +13 more·2015·New England Journal of Medicine

Abstract

BACKGROUND: Multiple myeloma cells uniformly overexpress CD38. We studied daratumumab, a CD38-targeting, human IgG1κ monoclonal antibody, in a phase 1-2 trial involving patients with relapsed myeloma or relapsed myeloma that was refractory to two or more prior lines of therapy. METHODS: In part 1, the dose-escalation phase, we administered daratumumab at doses of 0.005 to 24 mg per kilogram of body weight. In part 2, the dose-expansion phase, 30 patients received 8 mg per kilogram of daratumumab and 42 received 16 mg per kilogram, administered once weekly (8 doses), twice monthly (8 doses), and monthly for up to 24 months. End points included safety, efficacy, and pharmacokinetics. RESULTS: No maximum tolerated dose was identified in part 1. In part 2, the median time since diagnosis was 5.7 years. Patients had received a median of four prior treatments; 79% of the patients had disease that was refractory to the last therapy received (64% had disease refractory to proteasome inhibitors and immunomodulatory drugs and 64% had disease refractory to bortezomib and lenalidomide), and 76% had received autologous stem-cell transplants. Infusion-related reactions in part 2 were mild (71% of patients had an event of any grade, and 1% had an event of grade 3), with no dose-dependent adverse events. The most common adverse events of grade 3 or 4 (in ≥ 5% of patients) were pneumonia and thrombocytopenia. The overall response rate was 36% in the cohort that received 16 mg per kilogram (15 patients had a partial response or better, including 2 with a complete response and 2 with a very good partial response) and 10% in the cohort that received 8 mg per kilogram (3 had a partial response). In the cohort that received 16 mg per kilogram, the median progression-free survival was 5.6 months (95% confidence interval [CI], 4.2 to 8.1), and 65% (95% CI, 28 to 86) of the patients who had a response did not have progression at 12 months. CONCLUSIONS: Daratumumab monotherapy had a favorable safety profile and encouraging efficacy in patients with heavily pretreated and refractory myeloma. (Funded by Janssen Research and Development and Genmab; ClinicalTrials.gov number, NCT00574288.).

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Crossref · 10.1056/nejmoa1506348

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  • Daratumumab has shown substantial single-agent efficacy and a manageable safety profile in phase 1-2 studies involving patients with heavily pretreated relapsed or refractory multiple myeloma, with reported overall response rates of 29% and 36%.

    “Daratumumab, a human IgGκ monoclonal antibody that targets CD38, 8 has shown substantial single-agent efficacy and a manageable safety profile in phase 1-2 studies involving patients with heavily pretreated relapsed or refractory multiple myeloma, with reported overall response rates of 29% and 36%.9,10”

    From Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma. (2016) · cites this paper as [10]

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  • Elotuzumab targets SLAMF7, while daratumumab and isatuximab target CD38.

    “Elotuzumab targets SLAMF7; daratumumab and isatuximab target CD38 respectively.84–87”
  • Daratumumab is active in relapsed, refractory multiple myeloma.

    “Daratumumab is active in relapsed, refractory multiple myeloma.85”
  • After the implementation of guidelines from other studies of daratumumab regarding the management of infusion-related reactions, infusion-related reactions were consistent with daratumumab monotherapy and combination therapy, were mostly of grade 1 or 2, and usually occurred during the first infusion.

    “After the implementation of guidelines from other studies of daratumumab regarding the management of infusion-related reactions, infusion-related reactions were consistent with daratumumab monotherapy 9,10 and combination therapy, 18,19,32 were mostly of grade 1 or 2, and usually occurred during the first infusion.”
  • Daratumumab with lenalidomide and dexamethasone was associated with clinically manageable adverse events that were consistent with the known toxic effects of lenalidomide and dexamethasone and of daratumumab.

    “Daratumumab with lenalidomide and dexamethasone was associated with clinically manageable adverse events that were consistent with the known toxic effects of lenalidomide and dexamethasone 27,28,30,31 and of daratumumab.9,10”

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  1. [9]9. killing of multiple myeloma and other hematological tumors. J Immunol 2011; 186: 1840-8.

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Authors
Lokhorst, H. M., Plesner, T., Laubach, J. P., Nahi, H., Gimsing, P., Hansson, M., Minnema, M. C., Lassen, U., Krejcik, J., Palumbo, A., van de Donk, N. W. C. J., Ahmadi, T., Khan, I., Uhlar, C. M., Wang, J., Sasser, A. K., Losic, N., Lisby, S., Basse, L., Brun, N., & Richardson, P. G.
Affiliations
  • University of Copenhagen (DK)
  • University of Southern Denmark (DK)
  • Harvard University (US)
  • Karolinska University Hospital (SE)
  • Lund University (SE)
  • University Medical Center Utrecht (NL)
  • University of Turin (IT)
  • Janssen Research & Development (United States) (US)
  • Genmab (Denmark) (DK)
Venue
New England Journal of Medicine
Published
2015-09-24
Volume
373
Issue
13
Pages
1207-1219
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W1902692042
Cited by
1,117
References
27
Citations by year
2026: 39 · 2025: 57 · 2024: 63 · 2023: 87 · 2022: 83 · 2021: 134 · 2020: 131 · 2019: 108 · 2018: 129 · 2017: 125 · 2016: 143 · 2015: 14
FWCI
107.52
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Janssen Research and Development
Topics
  • Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Monoclonal and Polyclonal Antibodies Research
  • Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
Keywords
multiple myeloma, daratumumab, CD38, monoclonal antibodies, relapsed/refractory multiple myeloma, monotherapy, dose escalation, progression-free survival, overall response rate, infusion reactions, pharmacokinetics, autologous stem cell transplantation, lenalidomide-refractory disease, bortezomib-refractory disease, pneumonia, thrombocytopenia, complete response, very good partial response
MeSH terms
Adult, Aged, Antibodies, Monoclonal, Antineoplastic Agents, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Multiple Myeloma, Pneumonia, Thrombocytopenia, Disease-Free Survival, Drug Resistance, Neoplasm, ADP-ribosyl Cyclase 1

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