4CPS-133 Daratumumab (darzalex) for the treatment of multiple myeloma in a third-level hospital: variability of use and effectiveness

Background Daratumumab is a human monoclonal antibody that binds to CD38 protein, expressed in a high level in the tumour cells of multiple myeloma (MM), inhibiting their proliferation. It has been authorised in combination with bortezomib, melphalan and prednisone for newly diagnosed MM not candidates for an autologous haematopoietic stem cell transplant or in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for patients who have received at least one previous treatment and in monotherapy for adult patients with MM relapsed and refractory to treatment, who have previously received a proteasome inhibitor and an immunomodulatory. Purpose Assessment of prescription profile of Daratumumab for the treatment of MM in a third-level hospital and the effectiveness of different regimens in terms of progression-free survival (PFS). Material and methods Retrospective review of patients with MM who received treatment with Daratumumab from February 2017 to October 2018. Data were collected from the electronic prescribing system for Oncology Haematology patients, and electronic medical records. Results Ten patients received treatment with Daratumumab (60% males, 40% females, median age 68 years). DLd (daratumumab 16 mg/kg, lenalidomide 10 mg or 25 mg, dexamethasone 40 mg) every 28 days was prescribed for five patients (50%), one as first-line, one as second-line and three as third-line treatment. Median PFS was 10 months for the group of patients treated. Daratumumab 16 mg/kg monotherapy weekly every 28 days was prescribed for two patients (20%) both as third-line treatment and who died after 1 month of treatment. DABODEX regimen (Daratumumab 16 mg/kg, bortezomib 1.3 mg/m 2 , dexamethasone 20 mg) every 28 days was prescribed for three patients (30%), one as first-line treatment, one as second-line and one as third-line. Median PFS was 6 months in this group. Conclusion Prescription profile of Daratumumab for the treatment of MM in our series of patients is variable, with different scenarios of treatment and different results in terms of PFS. It is mandatory to update protocols in the use of daratumumab in our hospital to measure its use among different drug options, most importantly with promising therapeutic advances recently authorised for MM treatment. References and/or acknowledgements https://www.ema.europa.eu/documents/product-information/darzalex-epar-product-information_es.pdf No conflict of interest.