Other Brands/Names

Daratumumab is marketed under the brand name Darzalex.

How It Works

Daratumumab targets and binds to the CD38 protein, which is present on the surface of multiple myeloma cells (a type of bone marrow cancer). The CD38 protein supports the survival and growth of these cancer cells. When daratumumab attaches to this protein, it triggers the breakdown and death of the cancer cells, thereby slowing or stopping their growth.

Indications

This medication is primarily used for the treatment of multiple myeloma (bone marrow cancer). In addition, daratumumab is also prescribed for patients with amyloidosis, a condition in which abnormal protein deposits build up and cause organ damage.

Contraindications

Daratumumab should not be used in the following cases:

• Allergy to daratumumab

• Low platelet counts (thrombocytopenia)

• Low levels of white blood cells, particularly neutrophils (neutropenia)

• Pregnancy

• Active or reactive hepatitis B infection

Side Effects

Some commonly reported side effects include:

• Temporary decreases in red blood cells, white blood cells, and platelets

• Fatigue

• Nausea

• Back pain

• Cough

• Pain in the legs or joints

• Reduced appetite

• Diarrhea

• Chest muscle pain

• Headaches

• Elevated blood pressure

A serious and potentially life-threatening side effect is the reactivation of hepatitis B in patients who have a history of the disease.

Types

Daratumumab is available as an injectable solution with a strength of 100 mg/5 ml.

Dosage

Dosing depends on the drug combination used with daratumumab:

In combination with lenalidomide and dexamethasone

• 16 mg/kg body weight weekly until week 8

• 16 mg/kg every 2 weeks from weeks 9–24

• 16 mg/kg every 4 weeks from week 25 onward until clinical improvement

In combination with bortezomib and dexamethasone

• 16 mg/kg weekly until week 9

• 16 mg/kg every 3 weeks from weeks 10–24

• 16 mg/kg every 4 weeks from week 25 onward until improvement is seen

In combination with bortezomib, melphalan, and prednisone

• 16 mg/kg weekly for the first 6 weeks

• 16 mg/kg every 3 weeks from weeks 7–54

• 16 mg/kg every 4 weeks from week 55 onward

In combination with bortezomib, thalidomide, and dexamethasone

• 16 mg/kg weekly from weeks 1–8

• 16 mg/kg every 2 weeks from weeks 9–16

Safety

No studies have been conducted to establish the safety of daratumumab in animals or humans. However, based on how the drug works, it may lower blood cell and immune cell levels in developing fetuses. It is also not known whether the drug passes into breast milk. For these reasons, daratumumab is not recommended during pregnancy or breastfeeding.

Drug Interactions

The interactions of daratumumab with other drugs are currently unknown. There are no studies on its effects when combined with medications, alcohol, smoking, or certain foods. Patients should always inform their doctor about any medicines they are taking before starting treatment with daratumumab.

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