Dr. Costello on the Future of Isatuximab in Relapsed/Refractory Multiple Myeloma

Caitlin Costello, MD, associate clinical professor of medicine, University of California, San Diego, discusses the future of isatuximab in relapsed/refractory multiple myeloma.

In the ICARIA-MM trial, researchers added the CD38-directed monoclonal antibody isatuximab in combination with pomalidomide (Pomalyst) and dexamethasone. Isatuximab targets a slightly different epitope when compared with dexamethasone, but is overall very similar, says Costello. The introduction of isatuximab to the market has a potential to create competition within the market, which could allow for pricing differences.

There are some suggestions that isatuximab may have a slightly faster infusion rate and an improved safety profile, compared with other agents in this class, due to fewer infusion reactions. This may be mitigated by a potential future indication of daratumumab (Darzalex) when it is administered in a subcutaneous formulation. For the meantime, isatuximab appears to be another option as a monoclonal antibody, concludes Costello.

Isatuximab is currently being evaluated in the smoldering myeloma and light chain amyloidosis settings as well. It is unclear where it will land in the relapsed/refractory multiple myeloma space, she adds.