From the Guidelines
No, daratumumab is not considered traditional chemotherapy for multiple myeloma. Daratumumab (brand name Darzalex) is a monoclonal antibody that targets the CD38 protein found on myeloma cells. Unlike traditional chemotherapy, which broadly attacks rapidly dividing cells throughout the body, daratumumab works through a targeted immunotherapy approach. It binds specifically to the CD38 surface protein on myeloma cells and triggers several immune-mediated actions that lead to cancer cell death, including complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and direct apoptosis induction. Daratumumab is typically administered intravenously, with dosing schedules that vary depending on whether it's used alone or in combination with other agents. The targeted nature of daratumumab generally results in a different side effect profile compared to traditional chemotherapy, though it can cause infusion reactions, fatigue, and may affect blood counts. This distinction between targeted immunotherapy and traditional chemotherapy is important for patients to understand when considering treatment options for multiple myeloma, as noted in recent guidelines 1.
Some key points to consider about daratumumab include:
- Its mechanism of action, which is distinct from traditional chemotherapy 1
- Its use in combination with other agents, such as bortezomib and lenalidomide, for the treatment of multiple myeloma 1
- Its side effect profile, which includes infusion reactions, fatigue, and potential effects on blood counts 1
- Its potential benefits in terms of response rates and progression-free survival, as demonstrated in clinical trials 1
Overall, daratumumab is an important treatment option for patients with multiple myeloma, and its targeted mechanism of action and distinct side effect profile make it a valuable alternative to traditional chemotherapy.
From the Research
Definition of Chemotherapy
- Chemotherapy is typically defined as the use of chemical agents to treat diseases, particularly cancer.
- In the context of multiple myeloma, chemotherapy usually refers to the use of traditional cytotoxic agents that target rapidly dividing cells.
Daratumumab Mechanism of Action
- Daratumumab is a monoclonal antibody that targets CD38, a protein expressed on the surface of multiple myeloma cells 2.
- It works by inducing cell death and inhibiting tumor growth, but its mechanism of action is different from traditional chemotherapy.
Classification of Daratumumab
- Daratumumab is considered an immunotherapy or a targeted therapy, rather than a traditional chemotherapy 2, 3.
- It is often used in combination with other therapies, including lenalidomide and dexamethasone, to treat multiple myeloma 4, 5.
Clinical Efficacy of Daratumumab
- Daratumumab has shown significant clinical efficacy in the treatment of multiple myeloma, with improved response rates and progression-free survival compared to traditional chemotherapy 4, 5, 6.
- It is approved for use in patients with multiple myeloma who have received at least one prior therapy, and is also being evaluated in newly diagnosed patients 2, 5.
Safety Profile of Daratumumab
- Daratumumab has a relatively favorable safety profile, with common adverse events including infusion-related reactions, neutropenia, and thrombocytopenia 4, 5, 3.
- The subcutaneous formulation of daratumumab has been shown to have a lower risk of infusion reactions and decreased administration time compared to the intravenous formulation 3.