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Efficacy of daratumumab in newly diagnosed multiple myeloma patients with 1q21 gain
Hirono Iriuchishima1, Akio Saito2, Masahiro Mihara2
1Department of Hematology, Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma, Japan. iriuchishima.h@gmail.com.
Background:
Gain and amplification of 1q21 (1q21+) are adverse chromosomal aberrations of multiple myeloma (MM) that lead to refractoriness to a variety of therapies. While it is known that daratumumab, an anti-cancer monoclonal antibody, cannot overcome the disadvantage of 1q21+in relapsed/refractory MM patients, its benefit in newly diagnosed MM (NDMM) patients with 1q21+has not been clarified.
Patients:
We retrospectively evaluated 11 (55%) 1q21+patients (3 copies: 6, > 4 copies: 5) among 20 NDMM patients (median age, 74 years) who received daratumumab-containing regimens at Shibukawa Medical Center from October 2019 to October 2022.
Results:
The overall response rate was 82% for patients with 1q21+and 78% for patients without 1q21+. Median progression-free survival (PFS) and median overall survival (OS) were not reached in either group. Neither 1q21 copy number nor co-existence of other high-risk cytogenetic abnormalities significantly affected PFS or OS.
Conclusion:
Our preliminary data suggests that outcomes of daratumumab treatment in NDMM 1q21+patients might be non-inferior to those in non-1q21+patients.
Insights
Daratumumab treatment shows promising outcomes for newly diagnosed multiple myeloma (NDMM) patients with 1q21+ chromosomal aberrations. Preliminary data suggests similar efficacy compared to patients without this genetic abnormality.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- 1q21+ amplification is a negative prognostic factor in multiple myeloma (MM), often causing treatment resistance.
- Daratumumab's efficacy in newly diagnosed MM (NDMM) with 1q21+ remains unclear, despite its limitations in relapsed/refractory MM.
Purpose of the Study:
- To evaluate the efficacy of daratumumab-containing regimens in NDMM patients with 1q21+ genetic aberrations.
- To compare treatment outcomes between NDMM patients with and without 1q21+.
Main Methods:
- Retrospective analysis of 20 NDMM patients treated with daratumumab-based regimens.
- Included 11 patients (55%) with 1q21+ (3 or >4 copies) and 9 without.
- Data collected from October 2019 to October 2022.
Main Results:
- Overall response rates were 82% for 1q21+ and 78% for non-1q21+ groups.
- Median progression-free survival (PFS) and overall survival (OS) were not reached in either group.
- 1q21 copy number and other high-risk cytogenetics did not significantly impact PFS or OS.
Conclusions:
- Preliminary findings suggest daratumumab treatment outcomes in NDMM patients with 1q21+ may be comparable to those without this aberration.
- Daratumumab may overcome the negative prognostic impact of 1q21+ in the newly diagnosed setting.
