An evaluation of isatuximab, pomalidomide and dexamethasone for adult patients with relapsed and refractory multiple myeloma

ABSTRACT

Introduction

Despite therapeutic advances, myeloma remains an essentially incurable disease, with a median survival of approximately 8 − 10 years. Most patients will develop disease that is refractory to immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), and treatment regimens containing drugs with different mechanisms of action are necessary. Isatuximab is one such novel agent, an anti-CD38 monoclonal antibody (MoAb), and is the second drug in this class after daratumumab. This paper will consider the current role for isatuximab with pomalidomide for the treatment of relapsed/refractory myeloma (RRMM).

Areas covered

This review provides an overview of the pharmacological characteristics of isatuximab, and its clinical development including safety and efficacy data to date.

Expert opinion

Isatuximab in combination with pomalidomide and dexamethasone offers a new treatment option for those patients with RRMM who are refractory to PIs and lenalidomide, a patient group with poor prognosis and unmet clinical need. The challenge of where it is best placed in the treatment algorithm remains, particularly with the increasing application of daratumumab particularly in the front– and second-line settings.

KEYWORDS:

• Isatuximab
• pomalidomide
• relapsed myeloma
• refractory myeloma
• multiple myeloma

Article highlights

• Despite therapeutic advances, myeloma remains an essentially incurable disease. Most patients will develop disease that is refractory to immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), and treatment regimens containing drugs with different mechanisms of action are necessary.

• Isatuximab is an anti-CD38 monoclonal antibody (MoAb), the second drug in this class after daratumumab.

• Isatuximab in combination with pomalidomide and dexamethasone offers a new treatment option for those patients with relapsed myeloma who are refractory to PIs and lenalidomide.

• The challenge of where it is best placed in the treatment algorithm remains, particularly with the increasing application of daratumumab particularly in the front- and second-line settings.

• Isatuximab with pomalidomide is an attractive option for myeloma patients with impaired renal function.

Declaration of interest

HM Prince has received honoraria and on advisory boards for Janssen, Sanofi, Celgene and Bristol Myer Squibb. He has received research funding from Celgene and Bristol Myer Squibb.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded