Dr. Usmani on Mechanisms and Response Rates With Daratumumab in Myeloma

Saad Z. Usmani, MD, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Carolinas HealthCare System, discusses the mechanisms of daratumumab (Darzalex) as well as the reported response rates in combination with other agents in multiple myeloma.

Daratumumab can impact the NK and T-cell receptors, although one of the mechanisms in which it is effective is to have an expansion of CD8-positive T cells that appear to be clonal in some studies, Usmani explains. However, there are limited data to see what the effects of these immunologic changes will be in the long run.

With the triplet regimen of daratumumab, lenalidomide (Revlimid), and dexamethasone, Usmani adds that there are unprecedented depths of response. Additionally, there are patients who have achieved minimal-residual disease (MRD) negativity, including those in the relapse setting. While it depends on which MRD-negativity cutoff clinicians use, there are patients reaching this stage that was not previously commonly seen in practice, he says.