Re-treatment of patients refractory to daratumumab

Heinz Ludwig, MD of the Wilhelminen Cancer Research Institute, Vienna, Austria and Niels van de Donk, MD, PhD, of the University Medical Center, Amsterdam, discuss new advances for the re-treatment of patients who initially respond to daratumumab but then become resistant.
Dr. van de Donk explains that there is some, although limited, data which shows that patients who have been re-exposed to daratumumab after a few rounds of treatment have indeed responded to it. However, there is still a lot to learn about re-exposure to treatment and how to position it. Furthermore, mechanisms of resistance to daratumumab are also being looked at. It has been found that there is upregulation of compliment inhibitors at the time of resistance and a downregulation of the target antigen CD38. Therefore, there are now trials which consider the re-treatment of patients with daratumumab in combination with all-trans retinoic acid – this reduces compliment inhibitors and increases the target antigen. Additionally, for patients that relapse on daratumumab, other trials are interestingly looking at how effective it would be to further activate the immune system that has been improved by daratumumab by adding a checkpoint inhibitor.
Recorded at the 2017 European Multiple Myeloma Academy (EMMA) in Vienna, Austria.
This program was sponsored by Celgene through an unrestricted educational grant to Video Journal of Hematological Oncology.

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