Rapid response to single agent daratumumab is associated with improved progression-free survival in relapsed/refractory AL amyloidosis.

Autor: Cohen, Oliver C., Brodermann, Maximillian H., Blakeney, Iona J., Mahmood, Shameem, Sachchithanantham, Sajitha, Ravichandran, Sriram, Law, Steven, Lachmann, Helen J., Whelan, Carol J., Popat, Rakesh, Rabin, Neil, Yong, Kwee, Kyriakou, Charalampia, Shah, Raakhee, Cheesman, Simon, Worthington, Sarah, Hawkins, Philip, Gillmore, Julian D., Wechalekar, Ashutosh D.
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Zdroj: Amyloid; Sep2020, Vol. 27 Issue 3, p200-205, 6p
Abstrakt: Background: Daratumumab is a monoclonal antibody, which targets CD38; an antigen expressed on malignant plasma cells in AL amyloidosis thus providing a rationale for its use. Method: Patients treated with daratumumab monotherapy (2016–2019) for relapsed/refractory systemic AL amyloidosis were identified from the database at the UK National Amyloidosis Centre. Results: Of 50 evaluable patients, haematological responses at 3 months were: CR – 19 (38%), VGPR – 14 (28%), PR – 9 (18%) and no response – 8 (16%). Median time to response was 1 (1–6) month. Of assessable patients, cardiac, renal and hepatic responses were seen in 43.8%, 25.0% and 0% of patients whilst progression occurred in 25.0%, 12.5% and 37.5% respectively. Patients achieving a CR had longer median OS (not reached vs. 22.7 months [95% CI 17.0–28.4 months]) (p =.036). Furthermore, patients achieving a rapid response (at 1 month) had a longer median PFS (not reached vs. 9 months [95% CI 5.8–12.2 months]) (p =.013). Conclusion: Daratumumab monotherapy is effective in multiply-relapsed systemic AL amyloidosis and should be considered, if available, in patients who have not received prior daratumumab therapy. Responses are achieved rapidly and overall response rate was 84%. CR predicts overall survival whilst speed of response is predictive of a longer PFS. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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