Building On Outcomes With Isatuximab in Newly Diagnosed Myeloma

Commentary
Video

Next steps for research in the multiple myeloma space may include the development of novel CAR T-cell strategies and bispecific antibodies.

In a conversation with CancerNetwork® at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting,Thierry Facon, MD, spoke about building upon findings from the phase 3 IMROZ trial (NCT03319667), which demonstrated the efficacy of isatuximab-irfc (Sarclisa) plus bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (Isa-VRd) in patients with newly diagnosed transplant-ineligible multiple myeloma.

Although the Isa-VRd may become a standard of care for some elderly populations, Facon, a professor of hematology in the Department of Hematology at Lille University Hospital, discussed how next steps may involve exploring the potential benefits of this treatment in patients over 80 years old. Additionally, he highlighted how novel CAR T-cell strategies and bispecific antibodies may further improve upon the treatment outcomes observed with the Isa-VRd regimen.

At a median follow-up of 59.7 months, the median progression-free survival (PFS) was not reached with Isa-VRd vs 54.3 months in patients who received bortezomib, lenalidomide, and dexamethasone only (HR, 0.596; 98.5% CI, 0.406-0.876; P = .0005). Based on current trends in the PFS data, the median PFS with Isa-VRd is anticipated to be approximately 90 months.

Transcript:

This regimen will become a standard of care for a large proportion of elderly patients with myeloma. That being said, everything can be improved. In fact, we may want to look at patients over the age of 80 years so that we would be able to elaborate a regimen that will be suitable for very elderly patients. That's such an important question.

Then, we will have to implement, in different ways, new modalities for model mice. For example, CAR T strategies, bispecific antibodies, or new CELMoDs. You have several ways to improve on Isa-VRd. Also, considering that the median PFS will likely be over 80 months for the Isa-VRd arm, it will not be so easy. But of course, we must find something better.

Reference

Facon T, Dimopoulos MA, Leleu XP, et al. Phase 3 study results of isatuximab, bortezomib, lenalidomide, and dexamethasone (Isa-VRd) versus VRd for transplant-ineligible patients with newly diagnosed multiple myeloma (IMROZ). J Clin Oncol. 2024;42(suppl 16):7500. doi:10.1200/JCO.2024.42.16_suppl.7500

Recent Videos
According to Benjamin J. Golas, MD, PIPAC could be used as a bridging therapy before surgical debulking or between subsequent large surgical operations.
“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.
Earlier treatment with daratumumab may be better tolerated for patients with pretreated MRD-negative multiple myeloma.
The trispecific antibody JNJ-5322 demonstrated superior efficacy vs approved agents in multiple myeloma in results shared at the 2025 EHA Congress.
Despite CD19 CAR T-cell therapy exhibiting efficacy in patients with relapsed/refractory large B-cell lymphoma, less than half achieve long-term remission.
“Dendritic cell vaccines, CAR T-cell therapy, and things of that nature are holding some promise,” said Andrew Brenner, MD, PhD.
Related Content
89Zr-DFO-daratumumab Has Potential Imaging Benefits in Non-FDG–Avid Multiple Myeloma

89Zr-DFO-daratumumab Has Potential Imaging Benefits in Non-FDG–Avid Multiple Myeloma

Gina Mauro
June 30th 2025
Article

89Zr-DFO-daratumumab shows activity in identifying and localizing multiple myeloma, even in FDG-non-avid cases, per new phase 2 data.

An expert panel highlights key presentations in multiple myeloma, lymphoma, and other hematologic malignancies at the 2025 ASCO Annual Meeting.

CAR T and Transplantation Advances Across Hematologic Cancers at ASCO 2025

Rahul Banerjee, MD, FACP;Taha Al-Juhaishi, MD;Muhammad Salman Faisal, MD
June 9th 2025
Podcast

An expert panel highlights key presentations in multiple myeloma, lymphoma, and other hematologic malignancies at the 2025 ASCO Annual Meeting.

Compared with 18F-FDG, the use of 68Ga-NODAGA-LM3 appears to favor bone and brain lesion detection among patients with small cell lung cancer.

68Ga-NODAGA-LM3 May Effectively Evaluate Small Cell Lung Cancer Responses

Russ Conroy
June 28th 2025
Article

Compared with 18F-FDG, the use of 68Ga-NODAGA-LM3 appears to favor bone and brain lesion detection among patients with small cell lung cancer.

Experts in gynecologic cancer, genitourinary malignancies, and other disciplines highlight noteworthy clinical data slated for presentation at ASCO 2025.

Spotlighting Key Upcoming Presentations Across Oncology at ASCO 2025

Rachel N. Grisham, MD;MinhTri Nguyen, MD;Eric Singhi, MD;Douglas Adkins, MD;Benjamin Garmezy, MD
May 26th 2025
Podcast

Experts in gynecologic cancer, genitourinary malignancies, and other disciplines highlight noteworthy clinical data slated for presentation at ASCO 2025.

Tumor penetration of atigotatug in fuc-GM1-positive lung, liver, and bone lesions was observed in those with extensive-stage small cell lung cancer.

BMS-986279 Shows Feasibility as Non-Invasive fuc-GM1 Assessment in ES-SCLC

Roman Fabbricatore
June 27th 2025
Article

Tumor penetration of atigotatug in fuc-GM1-positive lung, liver, and bone lesions was observed in those with extensive-stage small cell lung cancer.

225Ac-LNC1011 targeted α therapy elicited an ORR of 50.0% in patients with PSMA-positive prostate cancer in a phase 1 trial.

Novel Targeted Therapy Shows Promise in PSMA-Positive Prostate Cancer

Tim Cortese
June 24th 2025
Article

225Ac-LNC1011 targeted α therapy elicited an ORR of 50.0% in patients with PSMA-positive prostate cancer in a phase 1 trial.