Practical Management of IV Daratumumab in MM

Ola C. Landgren, MD, PhD: My personal experience with daratumumab is that it’s a very efficacious drug. It can be combined with literally every drug that is FDA approved, to my knowledge. All the established combinations work very well in addition to daratumumab. You don’t see any strong adverse effects, except for the fact that with the intravenous administration, around 50% of patients experience an infusion reaction. With the subcutaneous administration, less than 10% of patients experience that. Over time, patients who had a reaction in the beginning don’t seem to have recurrent reaction. Those patients who did not have it in the beginning don’t develop it later. There are some laboratory abnormalities that we see over time. We see there could be drops in the IgG levels, and sometimes that could lead to infections. Infection is 1 of the adverse effects that has been reported. In some individual cases, we consider giving patients IVIG [intravenous immunoglobulin] for these reasons. But overall, it’s a very well-tolerated drug.

Beyond the fact that this is a very well-tolerated drug and highly efficacious, when the Ohio State University group presented at ASH [American Society of Hematology Annual Meeting] a couple of years ago in Atlanta, they showed that you could give daratumumab as a rapid infusion from dose 3 onward unless there were problems during the first and second infusion. I think everyone has implemented that, at least the larger centers. That has really made the drug even easier to give. You can give it intravenously for 90 minutes in a rapid infusion from dose 3 onward. That will also help deliver the drug.

Transcript edited for clarity.