A Great New Option For Multiple Myeloma Patients: Daratumumab Now Available As a Quick Shot, Replacing Long Infusions

Darzalex was initially approved in 2015 for intravenous administration and it was marketed as an antibody therapy, meaning that the drug targets a protein, CD38, on the surface of myeloma cells. By targeting this protein, Darzalex kills myeloma cells.

Dr. Nina Shah Discussing an Exciting Development in Delivery of Daratumumab in Multiple Myeloma Patients.

Darzalex kills myeloma cells directly but it also works to trigger natural immune responses in the body that will also help kill the myeloma cells. By blocking the CD38 protein on the surface of myeloma cells, the drug is almost exclusively toxic to myeloma cells rather than healthy cells. Johnson & Johnson's Janssen Biotech produced and tested a Darzalex injection for the treatment of adult patients with multiple myeloma and it was approved by the FDA. This injectable form of Darzalex contains the same properties as the intravenous Darzalex but also includes additions to the therapeutic, targeting more factors that promote cancer cell growth, effectively killing cancer cells while also trying to prevent their spread. As with the infusional version, it is a combination therapy utilizing other drugs to target myeloma cells to enhance cancer cell targeting.

The FDA approved injectable Darzalex  because of a phase 3 comparison study showing that it not only parallels the efficacy of the intravenous Darzalex but also removes the need for infusions, mitigating the side effects associated with IV infusions.

Dr. Nina Shah explains previous multiple myeloma therapies, which includes Daratumumab.

"This [subcutaneous Darzalex administration] is similar to what many of you may know from insulin shots or other shots you may have gotten. And what this allows is for the time that the Daratumumab or Darzalex is being given, to be much shortened. And you don’t need an I-V place at the chemotherapy suite. So you can imagine where usually you’d spend several hours getting therapy. Now you may spend only 30 minutes." says  Dr. Nina Shah, a hematologist at UCSF Health.

How Administering Darzalex Has Changed

Prior to the FDA’s recent approval, Darzalex was administered to multiple myeloma patients via intravenous infusion. This was paired with pre-infusion and post-infusion medications. Oncologists have described the extent of these protocols and how subcutaneous injections would alter the time scale. 

"One of the challenges that often patients have is the way that their Daratumumab [another name for Darzalex] is delivered and it’s initially given on a weekly schedule and then it goes to every other week and then it goes to once a month. But the time that it takes to receive that infusion can be quite lengthy. The first dose can often take eight to ten hours. The second dose is about three to three and a half hours." says Dr. Sagar Lonial, a hematologist at Emory School of Medicine.

As the injection is much faster than an infusion, it potentially becomes more appealing to patients requiring cancer treatment in a time where health centers are flooded with potential COVID-19 carriers and COVID-19 patients.

However, even with its impressive benefits, Darzalex can have side effects. One of the most potential adverse reactions is upper respiratory tract infections. Hematologists say this may prove to be particularly salient fact in era of COVID-19.

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