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Клиническая онкогематология
Article . 2025 . Peer-reviewed
License: CC BY NC SA
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Anti-CD38 Antibodies in Monotherapy for Patients with Relapsed/Refractory Multiple Myeloma: Real-World Clinical Practice and Results of Clinical Trials

Authors: Margarita Andreevna Ulyanova; V. I. Vorobyev; L. A. Bychenkova; S. V. Semochkin;

Anti-CD38 Antibodies in Monotherapy for Patients with Relapsed/Refractory Multiple Myeloma: Real-World Clinical Practice and Results of Clinical Trials

Abstract

AIM. To assess the personal experience with the use of anti-CD38 monoclonal antibodies (mAb) for the treatment of relapsed/refractory multiple myeloma (R/R ММ) patients enrolled in the international clinical trials (CT) as well as those treated in real-world clinical practice (RWCP). MATERIALS & METHODS. The present retrospective study includes 63 R/R ММ patients (43 men and 20 women) who received daratumumab or isatuximab monotherapy from 2016 to 2020. The age of patients was 44–80 years; the median time by the start of the therapy to be assessed was 65 years. The analyzed cohort included 24 patients enrolled in the international multi-center CTs (daratumumab IV was administered to 14, daratumumab SC was given to 5, and isatuximab IV was applied in 5 of them). In RWCP, all 39 patients received daratumumab IV. The median number of prior therapy lines in the total cohort was 4 (range 1–10), in the CT group it was 5 (range 2–10), and in the RWCP group it was 4 (range 1–7). Resistance to bortezomib and lenalidomide occurred essentially in all patients under this study. RESULTS. With the follow-up median of 20 months (range 1–62 months), overall response was 50 % in the CT group and 29.3 % in the RWCP group (p = 0.094). The 2-year progression-free survival in these groups of patients was 16.7 and 2.6 %, respectively (p = 0.052). In the CT group, the 2-year overall survival was reported to be 54.2 ± 10.2 % (median 26.5 months) vs. 34.6 ± 7.8 % (median 17 months) in the RWCP group (hazard ratio 0.47; p = 0.022). CONCLUSION. The outcomes of anti-CD38 mAb monotherapy in the RWCP group lag behind those in patients enrolled in the international multi-center CTs. Although approaches to R/R MM treatment continue to be improved, anti-CD38 mAb monotherapy provides a certain treatment niche for heavily pretreated patients with bone marrow hematopoietic exhaustion and cumulative organ toxicity in cases when administration of intensive triplets can cause hypertoxicity. Infusion-related reactions associated with daratumumab or isatuximab mostly occur on their first administration and are not worse than grade 1/2. A switch from IV to SC daratumumab shortens the administration time from a few hours to 3–5 minutes and considerably reduces the incidence of infusion-related reactions.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
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