Daratumumab injected under the skin (subcutaneous formulation) is in development for the treatment multiple myeloma (MM) as an alternative to currently approved daratumumab intravenous formulation. MM is a rare, incurable cancer of the plasma cells in the bone marrow where large amounts of abnormal plasma cells are produced and interfere with the production of platelets, red and white blood cells. People with MM will experience periods of time without symptoms followed by periods when the illness comes back (‘relapsed’ MM). Eventually the periods without symptoms will shorten and the illness will become immune to the drugs given to treat it (‘refractory’ MM).
Daratumumab is a type of immune therapy that acts by inhibiting the growth of cancer cells in MM. The intravenous formulation of daratumumab is already licensed in the UK for the treatment of MM. Subcutaneous administration of daratumumab may make it possible for patients to receive this emerging therapy more easily, safely (with lower rates of infusion reaction) and conveniently (with only a 3 to 5 minute administration versus several hours for the infusion formulation). If licensed, this new formulation has the potential to replace the existing intravenous route of administration while contributing to reduced healthcare costs and greater patient convenience.
Nivolumab works by improving the activity of white blood cells thereby increasing the ability of the immune system to kill cancer cells. Cabozantinib works to stop signals that cancer cells use to divide and grow. It is thought that when used in combination, both drugs may be more effective than each drug on its own. If licenced, nivolumab in combination with cabozantinib may improve long-term outcomes in mRCC patients who currently have limited treatment options.