Posted by on Jun 26, 2022 in Multiple Myeloma | 0 comments

In a nutshell

This study evaluated the long-term effectiveness and safety of isatuximab (Sarclisa) in combination with pomalidomide (Pomalyst) and low-dose dexamethasone (Decadron) (Pd) in previously treated patients with relapsed or refractory (r/r) multiple myeloma (MM). The data showed that isatuximab plus Pd combination significantly improved the overall survival compared to Pd alone in these patients.  

Some background

Multiple myeloma (MM) is a type of cancer that comes from blood cells called plasma cells. A high number of patients with MM experience relapse (the tumor grows after treatment) or are refractory (not responsive to the treatment) to standard treatment. Currently, the treatment strategies for r/r MM are based on the different combinations of conventional and novel drugs.

One standard treatment combination for r/r MM is pomalidomide (Pomalyst) combined with dexamethasone (Pd). Isatuximab is an immunotherapy drug that has been approved for the treatment of r/r MM. It has been shown to improve the outcomes of these patients when combined with Pd therapy. However, the long-term effectiveness and safety of isatuximab in combination with the Pd regimen in previously treated patients with r/r MM is still not known.

Methods & findings

This study involved 307 patients with r/r MM. Patients were randomly assigned into 2 groups. Group 1 included 154 patients who received isatuximab + Pd combination. Group 2 included 153 patients who received Pd alone. The average follow-up time was 35.3 months.

The average overall survival was 24.6 months in group 1 versus 17.7 months in group 2. Patients in group 1 were 24% more likely to have a better survival compared to patients in group 2.

The average survival without cancer worsening was 11.1 months in group 1 versus 5.9 months in group 2. Patients in group 1 were 40% more likely to survive without cancer worsening compared to patients in group 2.

73% of the patients in group 1 experienced serious treatment-related side effects compared to 60% of the patients in group 2. The most common side effects were low white blood cell counts (50% in group 1 vs 35% in group 2), pneumonia (23% in group 1 vs 21% in group 2), and low platelet counts (13% in group 1 vs 12% in group 2).

The bottom line

This study concluded that the isatuximab plus Pd combination significantly improved the overall survival compared to Pd alone in previously treated patients with r/r MM.  

The fine print

This study was sponsored by Sanofi, the manufacturers of isatuximab. The patients knew which treatment they were getting. This might have influenced the results. 

Published By :

The Lancet. Oncology

Date :

Feb 10, 2022

Original Title :

Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): follow-up analysis of a randomised, phase 3 study.

click here to get personalized updates