Daratumumab has improved outcomes in multiple myeloma. Its antigenic target and principal mechanisms of action are:

• A CD20 on clonal B cells, blocking BAFF-dependent survival signals
• B SLAMF7 on plasma cells, recruiting NK cells via engineered IL-15 fusion
• C BCMA on plasma cells, delivering a conjugated auristatin payload
• D CD38 on myeloma cells, mediating complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity and apoptosis ✓

Explanation

Daratumumab targets CD38, highly expressed on myeloma cells, and kills through complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, antibody-dependent phagocytosis and direct apoptosis. Elotuzumab targets SLAMF7, belantamab mafodotin is the BCMA-directed antibody-drug conjugate, and CD20 targeting is irrelevant in myeloma since plasma cells lose CD20 expression.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.