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Can Darzalex cure Multiple Myeloma?

Medically reviewed by Carmen Fookes, BPharm. Last updated on May 20, 2020.

Official Answer

by Drugs.com
  • Although Darzalex cannot cure multiple myeloma it can improve the quality and length of life in most people.
  • Unfortunately, there is currently no cure for multiple myeloma. However, the cancer can be managed successfully in many patients for years.
  • Darzalex is a monoclonal antibody. It may also be called a targeted treatment. Darzalex works by binding to a specific protein called CD38 on the surface of multiple myeloma cells, causing cell death.

Darzalex (daratumumab) is a targeted treatment that may be used to treat adult patients with multiple myeloma (bone marrow cancer). It works by blocking a specific protein called CD38 on stem cells causing cell death and reducing the numbers of other cells. It also helps your immune system identify and destroy multiple myeloma cells.

How effective is Darzalex?

Darzalex is considered an effective treatment for patients with multiple myeloma (MM) and demonstrates rapid and long-lasting responses, extending a person with MM's life expectancy. Trials report:

  • The addition of Darzalex to regimens containing other agents (for example Revlimid/dexamethasone) was associated with a 44% reduction in the risk of disease progression or death
  • A 50% reduction in the risk of disease progression or death was reported when Darzalex was added to other agents in patients aged older than 65 years who were unable to undergo a stem cell transplant
  • Adding Darzalex to Kyprolis and dexamethasone improved response rates from 75% to 84% and the rate of minimal residual disease was nearly 10-times higher in the three drugs group compared with the two-drug group
  • In the Pollux study, 91% of patients treated with Darzalex in combination with lenalidomide and dexamethasone responded compared with 75% treated with lenalidomide/dexamethasone alone
  • 90.9% of patients who relapsed following a stem cell transplantation were still alive one year following the start of Darzalex treatment.

How does Darzalex work?

A protein called CD38 exists on the surface of hematopoietic cells – these are the stem cells that give rise to other blood cells. CD38 has multiple functions, such as cell binding (including during inflammation), cell signaling, and regulating enzyme activity.

Darzalex binds strongly and specifically to CD38, and once bound induces an immune response that results in the death of myeloid cancer cells. Darzalex also reduces the numbers of myeloid-derived suppressor cells – these are immune cells that originate from bone marrow stem cells whose numbers are significantly increased during chronic infections and cancer, as a result of hematopoiesis (the formation of a range of different blood cells from bone marrow stem cells).

Antibodies are proteins that are used by the immune system to protect our body against foreign invaders, such as bacteria and viruses. They can be classified into five main subtypes IgA, IgD, IgE, IgG, and IgM based on the sequence and structure.

Darzalex is an IgG monoclonal antibody.

How is Darzalex given?

Darzalex is administered by infusion directly into a vein. Other medications, such as corticosteroids, antipyretics, and antihistamines are given before and after the infusion to help prevent serious side effects or an allergic reaction.

The first infusion needs to be given slowly (over approximately 7 to 8 hours) because there is a risk of allergic reactions associated with Darzalex. The risk of reactions decreases with subsequent infusions which can be given over about 4 hours for the second infusion and 3 hours for subsequent infusions.

Darzalex is usually given every one to three weeks for the first few weeks of treatment, depending on what other treatments you have received for multiple myeloma. Then the frequency of infusions is reduced to once every four weeks until your body no longer responds to Darzalex (indicated by the progression of multiple myeloma).

The effects of Darzalex on blood-typing tests may last for up to 6 months after stopping this treatment. Darzalex is usually given at a dosage of 16mg/kg of actual body weight.

Darzalex is often given with other medications to treat multiple myeloma, and the duration of treatment can depend on the tolerability of the whole regimen, not just Darzalex. Clinical trials have reported treatment durations of up to 25.3 months (range 0.1 month to 40.44 months).

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