SUBCUTANEOUS DARATUMUMAB: EXPERIENCE REPORT IN AN ONCOLOGY CLINIC IN RIO DE JANEIRO

Introduction: Daratumumab is a monoclonal antibody directed to CD38 and is indicated for the treatment of newly diagnosed, relapsed and/or refractory Multiple Myeloma through intravenous infusion. Although it is a drug with proven efficacy, it has a high risk of reaction related to the infusion and therefore its administration must be staggered. In order to reduce treatment time and bring more comfort to the patient, daratumumab associated with human hyaluronidase was developed, which increases tissue dispersion, ensuring the administration of large volumes subcutaneously. This is a new formulation of the drug and was released for use in August 2020 by the National Health Surveillance Agency (ANVISA). Objective: To present the routines implemented by a Rio de Janeiro oncology clinic for the adoption of subcutaneous daratumumab treatment. Methods: Online training with a nurse representing the laboratory responsible for the drug. After training the team, the institution established some routines to standardize the care of these patients. Results: The routines implemented were: administration of pre-chemotherapy (antihistamine, anti-pyretic and corticoid) and a 1-hour interval after the last pre-chemotherapy before administering daratumumab subcutaneously; standardization of needle for application; observation of 3 hours at the institution after administration of the medication on the first application; Patients who have already been treated with daratumumab, intravenously or subcutaneously, do not need observation after application. Conclusion: We consider that the training of professionals, together with the standardization of routines were essential for the implementation of safe medication administration, not only by reducing administration time, but also by bringing greater comfort and confidence in the treatment for nurses and patients.