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Wang Y, Li Y, Chai Y. Efficacy and safety of daratumumab in the treatment of multiple myeloma: a systematic review and meta-analysis. J Int Med Res 2021; 49:3000605211038135. [PMID: 34433331 PMCID: PMC8404651 DOI: 10.1177/03000605211038135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective To systematically evaluate the efficacy and safety of combination regimens containing daratumumab in patients with multiple myeloma (MM). Methods A systematic search of publications listed on electronic databases (PubMed®, The Cochrane Library, Science Direct and Web of Science) between inception and 13 November 2020 was conducted to find randomized controlled trials (RCTs) that included patients with MM that were treated with combination regimens containing daratumumab. Results A total of seven RCTs were included (n = 4268 patients). Meta-analysis showed that compared with the control group, the group containing daratumumab showed a significantly better overall response rate and a complete response or better. Daratumumab improved efficacy in both standard-risk and cytogenetically high-risk patients with MM. The prevalence of neutropenia (≥grade 3) and pneumonia was significantly higher in the daratumumab group compared with the control group. Conclusion The available evidence demonstrated that the clinical application of combination regimens containing daratumumab improved the efficacy in patients with MM and had acceptable safety.
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Affiliation(s)
- Yin Wang
- Department of Haematology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
| | - Yanqing Li
- Department of Haematology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
| | - Ye Chai
- Department of Haematology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
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Martino M, Canale FA, Alati C, Vincelli ID, Moscato T, Porto G, Loteta B, Naso V, Mazza M, Nicolini F, Ghelli Luserna di Rorà A, Simonetti G, Ronconi S, Ceccolini M, Musuraca G, Martinelli G, Cerchione C. CART-Cell Therapy: Recent Advances and New Evidence in Multiple Myeloma. Cancers (Basel) 2021; 13:2639. [PMID: 34072068 PMCID: PMC8197914 DOI: 10.3390/cancers13112639] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/26/2022] Open
Abstract
Despite the improvement in survival outcomes, multiple myeloma (MM) remains an incurable disease. Chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA) represents a new strategy for the treatment of relapsed/refractory MM (R/R). In this paper, we describe several recent advances in the field of anti-BCMA CAR T-cell therapy and MM. Currently, available data on anti-BCMA CART-cell therapy has demonstrated efficacy and manageable toxicity in heavily pretreated R/R MM patients. Despite this, the main issues remain to be addressed. First of all, a significant proportion of patients eventually relapse. The potential strategy to prevent relapse includes sequential or combined infusion with CAR T-cells against targets other than BCMA, CAR T-cells with novel dual-targeting vector design, and BCMA expression upregulation. Another dark side of CART therapy is safety. Cytokine release syndrome (CRS) andneurologic toxicity are well-described adverse effects. In the MM trials, most CRS events tended to be grade 1 or 2, with fewer patients experiencing grade 3 or higher. Another critical point is the extended timeline of the manufacturing process. Allo-CARs offers the potential for scalable manufacturing for on-demand treatment with shorter waiting days. Another issue is undoubtedly going to be access to this therapy. Currently, only a few academic centers can perform these procedures. Recognizing these issues, the excellent response with BCMA-targeted CAR T-cell therapy makes it a treatment strategy of great promise.
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Affiliation(s)
- Massimo Martino
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Filippo Antonio Canale
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Caterina Alati
- Hematology Unit, Hemato-Oncology and Radiotherapy Department, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (C.A.); (I.D.V.)
| | - Iolanda Donatella Vincelli
- Hematology Unit, Hemato-Oncology and Radiotherapy Department, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (C.A.); (I.D.V.)
| | - Tiziana Moscato
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Gaetana Porto
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Barbara Loteta
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Virginia Naso
- Stem Cell Transplant and Cellular Therapies Unit, Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, RC, Italy; (F.A.C.); (T.M.); (G.P.); (B.L.); (V.N.)
| | - Massimiliano Mazza
- Immunotherapy, Cell Therapy and Biobank (ITCB), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (M.M.); (F.N.)
| | - Fabio Nicolini
- Immunotherapy, Cell Therapy and Biobank (ITCB), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (M.M.); (F.N.)
| | - Andrea Ghelli Luserna di Rorà
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (A.G.L.d.R.); (G.S.)
| | - Giorgia Simonetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (A.G.L.d.R.); (G.S.)
| | - Sonia Ronconi
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (S.R.); (M.C.); (G.M.); (G.M.)
| | - Michela Ceccolini
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (S.R.); (M.C.); (G.M.); (G.M.)
| | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (S.R.); (M.C.); (G.M.); (G.M.)
| | - Giovanni Martinelli
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (S.R.); (M.C.); (G.M.); (G.M.)
| | - Claudio Cerchione
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (S.R.); (M.C.); (G.M.); (G.M.)
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