Published in:
Open Access
01-04-2021 | Multiple Myeloma | Original Article
Subcutaneous daratumumab in Asian patients with heavily pretreated multiple myeloma: subgroup analyses of the noninferiority, phase 3 COLUMBA study
Authors:
Shinsuke Iida, Takayuki Ishikawa, Chang Ki Min, Kihyun Kim, Su Peng Yeh, Saad Z. Usmani, Maria-Victoria Mateos, Hareth Nahi, Christoph Heuck, Xiang Qin, Dolly A. Parasrampuria, Katharine S. Gries, Ming Qi, Nizar Bahlis, Shigeki Ito
Published in:
Annals of Hematology
|
Issue 4/2021
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Abstract
The phase 3 COLUMBA study demonstrated noninferiority of subcutaneous daratumumab (DARA SC) to intravenous daratumumab (DARA IV) in relapsed or refractory multiple myeloma. We present a subgroup analysis of Asian patients from COLUMBA. Eligible patients had ≥ 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug, or were double refractory. Co-primary endpoints were overall response rate (ORR) and maximum trough concentration (
Ctrough). Secondary endpoints included rates of infusion-related reactions, progression-free survival, and patient-reported satisfaction with therapy. Sixty-seven Asian patients (DARA SC,
n = 30; DARA IV,
n = 37) were randomized, including 42 Japanese patients (DARA SC,
n = 18; DARA IV,
n = 24). Comparable ORRs for DARA SC versus DARA IV were seen in the Asian cohort (66.7% vs 43.2%) and Japanese-only cohort (61.1% vs 54.2%), including patients weighing ≤ 65 kg. Similarity of
Ctrough was seen in both Asian and Japanese-only cohorts; the ratio of the geometric mean of the
Ctrough concentrations for DARA SC/DARA IV was 143.96% (90% confidence interval (CI), 112.03–185.00%) and 148.02% (90% CI, 113.32–193.34%), respectively. The Asian cohort (both treatment groups) and Japanese-only cohort (DARA SC group) experienced higher rates of grade 3/4 cytopenias compared with the global COLUMBA population, occurring predominantly in patients of low bodyweight; no patients discontinued treatment due to cytopenias. The Cancer Therapy Satisfaction Questionnaire results generally favored DARA SC. In the Asian and Japanese-only cohorts, DARA SC was comparable to DARA IV. The efficacy, pharmacokinetic, safety, and satisfaction results were generally consistent with the global COLUMBA population regardless of patient bodyweight.
ClinicalTrials.gov Identifier: NCT03277105