Daratumumab (anti-CD38 monoclonal antibody) is approved for multiple myeloma. Which mechanism contributes to its antimyeloma effect?

• A Inhibition of proteasome function in plasma cells
• B Cross-linking CD38 to induce direct apoptosis via caspase-3 activation alone
• C Immune-mediated killing via ADCC, ADCP, and CDC against CD38-expressing myeloma cells ✓
• D Blockade of BCMA signaling essential for plasma cell survival

Explanation

Daratumumab kills myeloma cells through multiple immune effector mechanisms: ADCC (via Fc-gamma receptors on NK cells), ADCP (antibody-dependent cellular phagocytosis by macrophages), and CDC. It also has immunomodulatory effects by depleting CD38+ regulatory immune cells. Proteasome inhibition is bortezomib's mechanism; BCMA is targeted by belantamab mafodotin.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.