Real-World Retrospective Analysis of Daratumumab for Relapsed or Refractory Multiple Myeloma in Regional Australia

Abstract

Daratumumab is widely used for relapsed or refractory multiple myeloma, yet outcomes from regional Australian centers remain underreported. This retrospective study evaluated real-world treatment patterns between 2018 and 2023 and survival outcomes among patients receiving daratumumab-based therapy in two regional tertiary centers. Fifty-two patients were included. Median age was 74 years, and 59% had high-risk cytogenetics. Most patients received a combination of daratumumab, bortezomib, and dexamethasone (60%, 32). The overall response rate was 35%, including 10% complete responses and 25% very good partial responses. Median progression-free survival (PFS) was 13 months. Patients who received daratumumab at greater than first relapse had significantly longer PFS (hazard ratio 4.29, 95% confidence interval 1.94-9.47, p < 0.001). Median overall survival (OS) was 27 months. Prior autologous stem cell transplantation was not associated with differences in PFS or OS. Daratumumab-based combinations were feasible in a regional setting and yielded meaningful clinical outcomes in an older cohort with a high proportion of adverse cytogenetics.