Isatuximab-Based Regimens Versus Standard of Care in Myeloma

Adding isatuximab to standard-of-care (SOC) regimens improved rates of complete response (CR), very good partial response (VGPR), and measurable residual disease (MRD) negativity in patients with transplant-eligible, newly diagnosed multiple myeloma, according to a recent study.

The meta-analysis was led by Junaid Anwar, MD, of Baptist Hospitals of Southeast Texas, who presented results at the Twelfth Annual Meeting of the Society of Hematologic Oncology in Houston, Texas.

Dr. Anwar and colleagues conducted a comprehensive literature search on PubMed, EMBASE, Cochrane, and ClinicalTrials.gov and identified two phase III randomized clinical trials that examined the efficacy of isatuximab plus SOC regimens (IsKia and GMMG-HD7). The studies included a total of 960 patients. The IsKia trial compared isatuximab-carfilzomib-lenalidomide-dexamethasone (Isa-KRd) (n=151) versus KRd, and the GMMG-HD7 trial compared isatuximab-lenalidomide-bortezomib-dexamethasone (Isa-RVd) (n=330) versus RVd (n=328). Both trials used an isatuximab dose of 10 mg/kg.

Median follow-up was 20 months in the IsKia trial and 23 months in the GMMG-HD7 trial. According to a pooled analysis, isatuximab-based regimens showed a “significant achievement” of MRD compared with controls (odds ratio [OR]: 1.98; 95% CI, 1.38–2.95; P<0.05; I²=0). Adding isatuximab to KRd and RVd also showed improved efficacy compared with the controls in terms of CR (OR: 1.14; 95% CI, 0.73–1.80; P=0.56; I²=26), VGPR (OR: 1.87; 95% CI, 1.09–3.21; P<0.05; I²=30).

However, isatuximab-based regimens also showed an increased risk of neutropenia (relative risk [RR]: 1.62; 95% CI, 1.14–2.28; P<0.05; I²=0) and infections (RR: 1.32; 95% CI, 0.79–2.21; P=0.30; I²=0) compared with controls.

Reference

Anwar J, Anjum Z, Zarrar R, et al. Efficacy of isatuximab-based regimens compared to standard of care in transplant-eligible newly diagnosed multiple myeloma: a meta-analysis of phase III clinical trials. Abstract #MM-433. Presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology. September 4-7, 2024; Houston, Texas.