Optimal Pre-medication Strategy for Daratumumab

Clinical Pearls Podcasts published on July 3, 2017
Download Transcript Download Podcast
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Associate Professor
Department of Pharmacology
Department of Hematology and Medical Oncology
Emory University School of Medicine
Director, Phase I Clinical Trials Section
Winship Cancer Institute of Emory University
Atlanta, Georgia

Optimal Pre-medication Strategy for Daratumumab
  • Daratumumab
    • Anti-CD38 monoclonal antibody
    • Exceptional activity at all stages of multiple myeloma
    • Associated with first dose and first infusion reactions
  • Treatment-related adverse events association with daratumumab
    • Infusion reactions can be substantially minimized with optimal pre-medications
      • Dexamethasone
      • Acetaminophen
      • Diphenhydramine
      • H1 antagonists such as ranitidine
    • Pulmonary events
      • Can include
        • Cough
        • Shortness of breath
        • Other dyspneic type symptoms
      • CD38 expressed on basophils, predominantly in lung parenchymal tissue
      • Pre-medication: montelukast, a leukotriene receptor antagonist
        • Used to inhibit basophils and their degranulation
        • Reduces the effects of degranulating basophils and the resulting cough and shortness of breath
  • Timing
    • Patients will have these infusion reactions on the first infusion and may extend into the second infusion
    • Because the disease burden is reduced following the second infusion, the infusion reaction is also much less likely to occur
      • Reduction of premedications may be possible as patients continue
        on therapy
Last modified: June 16, 2017
Related Items by Author
Measuring Frailty in Patients Being Treated for Multiple Myeloma
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on July 17, 2017
Rash Management for Patients Taking IRd (Ixazomib-Lenalidomide-Dexamethasone)
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on June 19, 2017
How do I manage diarrhea in my patients taking ixazomib?
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on January 30, 2017
What prophylactic antithrombotic agents are safe to use with lenalidomide?
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on January 16, 2017
How do I manage renal dysfunction in my patient who is taking lenalidomide?
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on January 3, 2017
What do I do if my patient has an infusion reaction at home after receiving daratumumab?
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on December 19, 2016
What do I do if my patient has an infusion reaction on elotuzumab, even after premedication?
R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Clinical Pearls Podcasts published on December 14, 2016 in Podcasts