Subcutaneous Daratumumab Provides Speedier Multiple Myeloma Treatment

The CD38-directed monoclonal antibody daratumumab in its subcutaneous formulation (Darzalex Faspro) offers patients with multiple myeloma a quicker treatment experience with a similar adverse event (AE) profile to its intravenous (IV) formulation (Darzalex), said Stephanie Mompoint, APRN, in an interview with Oncology Nursing News.

Mompoint, a research advanced practice nurse at the University of Miami Health System, emphasized that with the subcutaneous formulation, patients are able to get in and out of the clinic in less time since they do not have to sit through a lengthy infusion. While subcutaneous is widely tolerable, it requires some premedications to avoid reactions, as Gina Fries, PA-C, a physician assistant at the University of Rochester Medical Center, pointed out in a prior interview with Oncology Nursing News.

“We do this standard Tylenol [acetaminophen], Benadryl [diphenhydramine], dexamethasone combination that is for multiple drugs, including daratumumab infusions and subcutaneous injections," said Fries. “For the very first 4 doses of subcutaneous daratumumab, we give montelukast beforehand.”

Subcutaneous daratumumab should be injected slowly in the abdomen, where the hyaluronidase helps the drug absorb into the fatty tissue, according to Mompoint.

Transcript

Daratumumab has been approved as a monoclonal antibody drug as a treatment for [patients with] multiple myeloma. The subcutaneous form of the drug has been approved to be used, as well. It’s given as one infusion, combining daratumumab with hyaluronidase. These 2 components really help for better absorption of the daratumumab in the fatty tissue. The AEs are expected to be the same [as for the IV formulation]. That’s why it’s important to premedicate patients, just like you would have with IV daratumumab.

The benefit is that to the patient, it’s a shorter stay in the infusion unit. Daratumumab must be given in the infusion unit; it’s not something that a patient can take at home on their own. The patient will come in and have the injection administered by a nurse. It’s a 15-ml injection given slowly in the abdomen.

The benefit for the patient is that they don’t have to sit here and have an IV inserted and stay in the infusion unit for 3 to 4 hours.

This transcript has been edited for clarity and conciseness.