Benjamin Reardon, Ian Kerridge, Tasman Armytage
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.