Efficacy of isatuximab in combination with steroids for the treatment of relapsed/refractory multiple myeloma patients exhibiting only biochemical progression-A single center retrospective study

• Published in: European journal of haematology Vol. 111; no. 4; pp. 628 - 635
• Main Authors: Regidor, Bernard Sean, Jew, Scott, Goldwater, Marissa-Skye, Beatty, Bethany Marie, Bujarski, Sean, ElSayed, Adam, Danis, Ryan, Kim, Susanna, Swift, Regina, Schwartz, Gary, Berenson, James R
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.10.2023
• Subjects: Dexamethasone; Leukopenia; Lymphopenia; Methylprednisolone; Multiple myeloma; Neutropenia; Patients; Respiratory tract infection; Steroid hormones; Thrombocytopenia; isatuximab; anti-CD38; relapsed/refractory; multiple myeloma
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14057

Isatuximab is approved for treatment of relapsed/refractory multiple myeloma (RRMM) with dexamethasone and carfilzomib or pomalidomide. Patients receiving these three-drug regimens have exhibited more Grade ≥ 3 adverse events (AEs) compared to the two-drug class combination of isatuximab and steroids alone. Thus, this single-center retrospective study investigated the efficacy of isatuximab with dexamethasone and methylprednisolone (ISAdm) for RRMM patients showing only biochemical progression (BP) of their disease. Twenty-four RRMM patients exhibiting only BP were administered isatuximab at 10 mg/kg with dexamethasone once weekly for cycle 1 of a 28-day cycle, followed by every other week for each cycle thereafter. Starting in cycle 2, oral methylprednisolone was added every other day stopping 48 h before and starting 48 h after each dexamethasone infusion. Overall response rate and clinical benefit rate were 63% and 79%, respectively. Progression free survival was 12.9 months. There were only 5 AEs of Grade ≥ 3 which included lymphocytopenia (13%), leukopenia (4%), and neutropenia (4%). No Grade ≥ 3 AE related to respiratory infection, anemia, or thrombocytopenia were reported. This study shows that the two-drug class combination of ISAdm is an effective and well tolerated treatment option for RRMM patients exhibiting only BP.