Abstract:Objective To investigate the efficacy and safety of daratumumab-based regimens in the treatment of patients with multiple myeloma, and to compare the impact of different regimens and treatment durations on patients’ progression -free survival (PFS). Methods A retrospective analysis was conducted on the clinical data of 81 patients with multiple myeloma treated with daratumumab at the Affiliated Hospital of Nantong University between June 2020 and December 2023 (77 cases can be evaluated for efficacy). Based on treatment duration, patients were divided into short-course group (≤3 months, n=30), medium-course group (4-8 months, n=22), and long-course group (≥9 months, n=25) groups. According to different chemotherapy regimens, patients were categorized into the Dd group (daratumumab combined with dexamethasone, n=7) and the multidrug combination group (daratumumab combined with a proteasome inhibitor and/or an immunomodulatory agent, n=70). Their efficacy, survival outcomes, and adverse reactions were analyzed. Results The deadline of follow-up was December 31, 2023. The overall response rate (ORR) of 77 patients was 87.0%, including 9 cases of stringent complete response, 11 cases of complete response, 15 cases of very good partial response, 16 cases of partial response, 16 cases of minimal response, 6 cases of stable disease, and 4 cases of progressive disease. The ORR in the multidrug combination group was significantly higher than that in the Dd group [90.0% (63/70) vs 57.1% (4/7), P=0.043]. Compared with the short-course group, the long-course group showed superior ORR [100.0% (25/25) vs 76.7% (23/30), χ²=6.684, P=0.010]and median PFS (2.99 years vs 2.02 years, P= 0.005). Adverse reactions were primarily hematological toxicities, with most being grade 1-2. Conclusion Daratumumab -based regimens demonstrate confirmed efficacy in treating patients with multiple myeloma, with a low incidence of severe adverse reactions during treatment, and can effectively improve the depth of response and PFS.