For patients receiving daratumumab as treatment of relapsed/refractory multiple myeloma (RRMM), a new study has revealed a rapid third-infusion protocol to be both safe and well tolerated, according to results reported in the Journal of Oncology Pharmacy Practice.
Eligible patients with RRMM in this study received their first 2 intravenous infusions of daratumumab at standard administration rates, as monotherapy or as part of a combination treatment. This observational study was conducted at the University Hospital in Dijon, France, and it examined the effects of giving a third (or later) infusion over 90 minutes instead of the usual 210 minutes.
In this rapid infusion process, the rate of infusion began at 200 mL/hour for 30 minutes. If infusion-related reactions (IRRs) did not occur, then administration was continued at a rate of 400 mL/hour, for a total of 500 mL administered. Premedication therapies were given as recommended for all patients. The primary study outcome was safety with this approach.
One or more 90-minute infusions of daratumumab were given to 25 patients in this study, for a total of 53 infusions lasting 90 minutes. Comorbidities existed in 10 patients (40%).
Grade 1 hypertension occurred in 2 patients, and grade 1 hypotension occurred in 2 patients. These alterations of blood pressure were reported to occur in patients who had poorly controlled blood pressure prior to the intervention. Grade 3 to 4 hypertension or hypotension did not occur. Fatigue was reported in 5 patients (9%). IRRs were noted for a total of 4 patients (8%), and all of these were at grade 1.
With no evidence of grade 2 or higher IRRs in this study, the researchers considered the rapid infusion protocol to be safe. “Following these positive results, we have decided to maintain the new protocol in our facility,” the researchers wrote in their report.
Lombardi J, Boulin M, Devaux M, et al. Safety of ninety-minute daratumumab infusion. J Oncol Pharm Pract. Published online August 30, 2020. doi:10.1177/1078155220951231