Henk M Lokhorst1, Torben Plesner, Jacob P Laubach, Hareth Nahi, Peter Gimsing, Markus Hansson, Monique C Minnema, Ulrik Lassen, Jakub Krejcik, Antonio Palumbo, Niels W C J van de Donk, Tahamtan Ahmadi, Imran Khan, Clarissa M Uhlar, Jianping Wang, A Kate Sasser, Nedjad Losic, Steen Lisby, Linda Basse, Nikolai Brun, Paul G Richardson. 1. From the Department of Hematology, University Medical Center Utrecht, Utrecht (H.M.L., M.C.M., N.W.C.J.D.), and the Department of Hematology, VU University Medical Center, Amsterdam (H.M.L., N.W.C.J.D.) - both in the Netherlands; Vejle Hospital and University of Southern Denmark, Vejle (T.P., J.K.), and Rigshospitalet and University of Copenhagen (P.G., U.L.) and Genmab (N.L., S.L., L.B., N.B.), Copenhagen - all in Denmark; Dana-Farber Cancer Institute, Harvard Medical School, Boston (J.P.L., P.G.R.); Karolinska Institute and the Department of Medicine, Division of Hematology, Karolinska University Hospital at Huddinge, Stockholm (H.N.), and Skåne University Hospital and Lund University, Lund (M.H.) - all in Sweden; Myeloma Unit, Division of Hematology, University of Turin, Turin, Italy (A.P.); Janssen Research and Development, Spring House, PA (T.A., C.M.U., A.K.S.); and Janssen Research and Development, Raritan, NJ (I.K., J.W.).
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.).
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.).
Authors: Peter M Voorhees; Jonathan L Kaufman; Jacob Laubach; Douglas W Sborov; Brandi Reeves; Cesar Rodriguez; Ajai Chari; Rebecca Silbermann; Luciano J Costa; Larry D Anderson; Nitya Nathwani; Nina Shah; Yvonne A Efebera; Sarah A Holstein; Caitlin Costello; Andrzej Jakubowiak; Tanya M Wildes; Robert Z Orlowski; Kenneth H Shain; Andrew J Cowan; Sean Murphy; Yana Lutska; Huiling Pei; Jon Ukropec; Jessica Vermeulen; Carla de Boer; Daniela Hoehn; Thomas S Lin; Paul G Richardson Journal: Blood Date: 2020-08-20 Impact factor: 22.113
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Authors: Giovanni Palladini; Efstathios Kastritis; Mathew S Maurer; Jeffrey Zonder; Monique C Minnema; Ashutosh D Wechalekar; Arnaud Jaccard; Hans C Lee; Naresh Bumma; Jonathan L Kaufman; Eva Medvedova; Tibor Kovacsovics; Michael Rosenzweig; Vaishali Sanchorawala; Xiang Qin; Sandra Y Vasey; Brendan M Weiss; Jessica Vermeulen; Giampaolo Merlini; Raymond L Comenzo Journal: Blood Date: 2020-07-02 Impact factor: 22.113