Safety of Rapid Daratumumab Infusion in RRMM

The recommended administration rates of intravenous (IV) daratumumab (DARA) result in infusion times of 6.5 hours, 4.5 hours, and 3.5 hours for the first, second, and subsequent infusions, respectively. DARA, which is approved as monotherapy or in combination with bortezomib and dexamethasone (DVd) or lenalidomide and dexamethasone (DRd), has an excellent safety profile, with moderate-grade infusion-related reactions (IRRs) occurring mostly during the first infusion.

This report shares results of a single center’s safety study of the rapid-infusion DARA (ie, over 90 minutes). The only inclusion criterion was previous receipt of ≥6 doses of DARA according to standard practice. Previous IRR was not an exclusion criterion.

Premedications included chlorphenamine 10 mg, paracetamol 1000 mg, and IV dexamethasone 20 mg or 40 mg, depending on the use of DVd or DRd. DARA was administered at an infusion rate of 200 mL/hour for the first 30 minutes, increasing to 400 mL/hour for the next 60 minutes.

From February to June 2019, researchers evaluated 24 consecutive patients with relapsed or refractory multiple myeloma (RRMM) who received DARA over 90 minutes. Their median age was 65 years (range, 42-78 years). Six (30%) patients were receiving treatment with DARA alone, 7 (29%) patients with DVd, and 11 (46%) patients with DRd. They received a median of 2 prior treatments (range, 2-5). The median number of DARA infusions prior to starting the rapid-infusion protocol was 12 (range, 6-24).

In this study of rapid-infusion DARA, no adverse events were observed during the infusion or during the following 30 minutes after completion. Rapid-infusion DARA was safe in patients who experienced grade 1 (40%) and grade 2 (10%) anemia, in those with a history of immediate hypersensitivity reactions (20%) to drugs or allergens, and in a patient with concomitant chronic obstructive pulmonary disease. All patients received rapid infusions of DARA during subsequent visits.

Researchers conclude that use of a 90-minute infusion time for DARA is well-tolerated and allows considerable time-savings for patients with RRMM, potentially enhancing adherence to treatment.

Abstract FP-150: Antonioli E, Attardi E, Staderini M, et al. Safety of Rapid Daratumumab Infusion in Relapsed and Refractory Multiple Myeloma

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