| Multiple Myeloma

Darzalex Faspro vs Velcade

Side-by-side clinical, coverage, and cost comparison for multiple myeloma.

Deep comparison between: Darzalex Faspro vs Velcade with Prescriber.AI

AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.

Safety signalsVelcade has a higher rate of injection site reactions vs Darzalex Faspro based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Velcade but not Darzalex Faspro, including UnitedHealthcare

Category

Darzalex Faspro

Velcade

At A Glance

RouteSC injection

FrequencyWeekly, then every 2 weeks, then every 4 weeks

ClassCD38-directed monoclonal antibody

RouteSC or IV injection

FrequencyTwice weekly

ClassProteasome inhibitor

Indications

Multiple Myeloma
Smoldering myeloma
Light chain (AL) amyloidosis

Multiple Myeloma
Carcinoma in situ of other and unspecified small intestine NOS

Dosing

Multiple Myeloma 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until disease progression. Dosing schedule varies by combination regimen (with lenalidomide-dexamethasone, bortezomib-melphalan-prednisone, bortezomib-thalidomide-dexamethasone, bortezomib-lenalidomide-dexamethasone, bortezomib-dexamethasone, pomalidomide-dexamethasone, or carfilzomib-dexamethasone) or as monotherapy.

Smoldering myeloma 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until diagnosis of multiple myeloma or maximum 3 years.

Light chain (AL) amyloidosis 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes in combination with bortezomib-cyclophosphamide-dexamethasone. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until disease progression or maximum 2 years.

Multiple Myeloma 1.3 mg/m2 SC or IV; previously untreated: twice weekly (Days 1, 4, 8, 11) in cycles 1-4 then once weekly (Days 1, 8, 22, 29) in cycles 5-9 with melphalan and prednisone for 9 six-week cycles; relapsed: twice weekly (Days 1, 4, 8, 11) every 3 weeks as single agent or with dexamethasone.

Carcinoma in situ of other and unspecified small intestine NOS 1.3 mg/m2 IV twice weekly (Days 1, 4, 8, 11) for 2 weeks followed by a 10-day rest period, in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (VcR-CAP) for 6 three-week cycles.

Contraindications

Severe hypersensitivity to daratumumab, hyaluronidase, or any component of the formulation

Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
Intrathecal administration

Drug Interactions

287View drug interactions

1286View drug interactions

Adverse Reactions

Most common (>=20%) Upper respiratory tract infection, fatigue, peripheral neuropathy, musculoskeletal pain, constipation, diarrhea, insomnia, rash, edema, pyrexia, nausea, cough, dyspnea, sensory neuropathy, injection site reactions, infusion reactions, headache, decreased appetite, sleep disorder

Serious Pneumonia, cardiac failure, sepsis, thromboembolism, COVID-19, neutropenia, thrombocytopenia, arrhythmia, cardiac arrest, herpes zoster, hepatitis B reactivation, cytomegalovirus infection, listeriosis, atrial fibrillation, pancreatitis, pulmonary edema, anaphylactic reaction

Most common (>=10%) Nausea, diarrhea, fatigue, peripheral neuropathies, thrombocytopenia, vomiting, constipation, pyrexia, anorexia, anemia, headache, neutropenia, rash, paresthesia, dizziness, weakness

Serious Diarrhea, vomiting, pyrexia, nausea, dehydration, thrombocytopenia, pneumonia, dyspnea, peripheral neuropathies, herpes zoster

Postmarketing Cardiac tamponade, bilateral deafness, optic neuropathy, blindness, ischemic colitis, progressive multifocal leukoencephalopathy, herpes meningoencephalitis, posterior reversible encephalopathy syndrome, Guillain-Barre syndrome, demyelinating polyneuropathy, acute diffuse infiltrative pulmonary disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, acute febrile neutrophilic dermatosis

Pharmacology

Daratumumab is a CD38-directed IgG1 kappa monoclonal antibody that induces tumor cell death through multiple immune-mediated mechanisms including complement-dependent cytotoxicity, antibody-dependent cell-mediated cytotoxicity, antibody-dependent cellular phagocytosis, and direct apoptosis via Fc-mediated crosslinking.

Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells; inhibition of this pathway disrupts homeostatic proteolysis, affecting multiple signaling cascades and leading to cell death in various cancer cell types including multiple myeloma.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Darzalex Faspro