Outcomes of anti-CD38 isatuximab plus pomalidomide and dexamethasone in five relapsed myeloma patients with prior exposure to anti-C38 daratumumab: case series

Figures & data

Table 1. Baseline patient, disease and treatment characteristics of 5 IsaPomDex patients with prior daratumumab exposure.

Baseline characteristics		IsaPomDex patients with prior daratumumab exposure (n = 5)
		I	II	III	IV	V
Patient	Age (years)	73	62	77	52	51
	Sex (M/F)	M	F	M	F	F
	Performance status (PS)	1	3	1	1	1
	Co-morbidity (CCI score)	4	4	4	1	1
	Anaemia (Y/N)	Y	Y	Y	Y	Y
	Hypercalcaemia (Y/N)	N	N	N	Y	N
	e-GFR	45	<10	53	75	32
Disease	MM subtype	IgA	IgG	LC	IgA	IgG
	Elevated LDH (Y/N)	Y	N	N	NK	NK
	ISS staging	2	2	3	NK	NK
	Cytogenetic risk	SR	SR	HR	HR	NK
	Amyloidosis (Y/N)	N	N	N	N	N
	Plasma cell leukaemia-PCL (Y/N)	N	N	N	Y	N
	Extramedullary-EM disease (Y/N)	N	N	N	Y	N
Prior therapies	Number of therapies	3	3	3	3	3
	Prior transplant (Y/N)	N	N	N	Y	Y
	Prior alkylator (Y/N)	Y	Y	Y	Y	Y
	Prior PI (Y/N)	Y	Y	Y	Y	Y
	Prior IMiD (Y/N)	Y	Y	Y	Y	Y
	Name of last IMiD used	Len	Len	Len	Len	Len
	Primary refractory to IMiD (Y/N)	N	N	N	N	N
	R/R to prior IMiD (Y/N)	Y	Y	Y	Y	Y
	Prior daratumumab (Y/N)	Y	Y	Y	Y	Y
	Prior HDACi (Y/N)	N	N	N	N	N
Prior dara	Name of prior dara-regimen	DVd	Dara-mono	DVd	DVd	DVd
	Number of cycles received	2	1	13	5	1
	Best response achieved	VGPR	MR-SD	VGPR	PD	PD
	Reason for discontinuation (Tox/PD/Other)	Other^a	G4 sepsis	PD	PD	PD
	Dara was last line prior to IsaPomDex (Y/N)	N	Y	N	N	N
	End of dara to start of Isa (months)	8.3	2	5.3	4.5	10

Abbreviations: PS, performance status; CCI, Charlson co-morbidity index; EM, extramedullary; G, grade; MM, multiple myeloma; ISS, international staging system for MM; PI, proteasome inhibitor; IMiD, immunomodulatory drug; Len, lenalidomide; HDACi, histone deacetylase inhibitor; IsaPomDex, isatuximab with pomalidomide and dexamethasone; SR, standard risk; HR, high risk; R/R, relapsed/refractory; PD, progressive disease; VGPR, very good partial response; Y, Yes; N, No. High risk cytogenetics is defined as one or more of the following features: t(4;14), t (14;16), del(17p), DVd (daratumumab with pomalidomide and dexamethasone), Dara-mono (daratumumab monotherapy).

^a Patient I achieved VGPR with DVd therapy and experienced peripheral neuropathy, did not relapse on therapy but was switched to Len-based oral therapy during the pandemic to minimize hospital visits and prevent the risk of COVID-19 infection.

Table 2. Outcomes of IsaPomDex in 5 patients with prior daratumumab exposure.

Outcomes		IsaPomDex patients with prior daratumumab exposure (n = 5)
		I	II	III	IV	V
IsaPomDex	Number of cycles to date	4	1	2	3	1
	Pomalidomide dose reduction (Y/N)	N	N	N	Y	N
	Dex dose reduction (Y/N)	Y	N	N	N	Y
	Tx discontinuation (Y/N)	N	Y	Y	Y	Y
	Reason for discontinuation (Tox/PD/Death)	N/A	Death	Death	Death	Death
Efficacy	Best response achieved	MR-SD	PD	PR	PD	PD
	Time to best response (months)	1.2	0.9	0.7	1.6	0.8
	Primary refractory to IsaPomDex (Y/N)	N	Y	N	Y	Y
	R/R to IsaPomDex (Y/N)	Y	N	N	N	N
	Time from start of Tx to relapse (months)	2.3	0.9	N/A	1.6	0.8
	Subsequent treatment started (Y/N)	N	N	N	N	N
Toxicity	Number of AEs	2	0	3	1	1
	Number of ≥ G3 AEs	1	0	2	1	0
	Haem AEs (Y/N)	N	N	Y	Y	N
	Non-haem AEs (Y/N)	Y	N	Y	N	Y
	Infections (Y/N)	N	N	Y	N	N
Survival	Duration of follow up (months)	3.4	0.9	1.6	2.7	1.1
	Death event (Y/N)	N	Y	Y	Y	Y
	Cause of death	N/A	PD	COVID-19	PD	PD

Abbreviations: IsaPomDex, isatuximab with pomalidomide and dexamethasone; Tx, treatment; Y , Yes; N, No; N/A, not applicable; MR, minimal response; SD, stable disease; PD, progressive disease; PR, partial response; AE, adverse event.

Data availability statement

All available data relating to this report are presented in the manuscript and the accompanying tables (Tables 1 and 2).