Home-Based Daratumumab in Patients With Multiple Myeloma

OBJECTIVE: Multiple myeloma is an incurable cancer with lifelong treatment needs. This, together with a global nursing shortage, calls for new approaches for future treatment. In this study, we therefore investigated the feasibility of home-based subcutaneous daratumumab administered by primary care nurses outside the hospital.

METHODS: Applying a mixed-methods prospective design, we included 30 patients; 18 had completed ≥ 6 cycles of daratumumab treatment, and 12 were newly started. New patients were followed for six 28-day cycles, with every second treatment administered outside the hospital. Patients already on treatment were followed for seven cycles with 2/3 treatments administered outside the hospital.

RESULTS: Of 123 administrations planned at the hospital, 122 (97.6%) were administered and three were cancelled. Of 144 administrations planned outside the hospital, 133 (92.4%) were administered, six were redirected to the hospital, and five were cancelled. No significant difference between numbers of cancellations/redirections was observed. Patients spent significantly longer time on treatment at the hospital, even when deducting travel time. Reducing patients' visits to the hospital did not cause additional unplanned contacts with the healthcare system.

CONCLUSION: This study thus concludes that administration of daratumumab outside the hospital is safe, feasible, and time saving.

TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05306587.