A dose-finding Phase 2 study of single agent isatuximab (anti-CD38 mAb) in relapsed/refractory multiple myeloma

Joseph Mikhael, Joshua Richter, Ravi Vij, Craig Cole, Jeffrey Zonder, Jonathan L. Kaufman, William Bensinger, Meletios Dimopoulos, Nikoletta Lendvai, Parameswaran Hari, Enrique M. Ocio, Cristina Gasparetto, Shaji Kumar, Corina Oprea, Marielle Chiron, Claire Brillac, Eric Charpentier, Jesús San-Miguel, Thomas Martin

Research output: Contribution to journalArticle

Abstract

A Phase 2 dose-finding study evaluated isatuximab, an anti-CD38 monoclonal antibody, in relapsed/refractory multiple myeloma (RRMM; NCT01084252). Patients with ≥3 prior lines or refractory to both immunomodulatory drugs and proteasome inhibitors (dual refractory) were randomized to isatuximab 3 mg/kg every 2 weeks (Q2W), 10 mg/kg Q2W(2 cycles)/Q4W, or 10 mg/kg Q2W. A fourth arm evaluated 20 mg/kg QW(1 cycle)/Q2W. Patients (N = 97) had a median (range) age of 62 years (38–85), 5 (2–14) prior therapy lines, and 85% were double refractory. The overall response rate (ORR) was 4.3, 20.0, 29.2, and 24.0% with isatuximab 3 mg/kg Q2W, 10 mg/kg Q2W/Q4W, 10 mg/kg Q2W, and 20 mg/kg QW/Q2W, respectively. At doses ≥10 mg/kg, median progression-free survival and overall survival were 4.6 and 18.7 months, respectively, and the ORR was 40.9% (9/22) in patients with high-risk cytogenetics. CD38 receptor density was similar in responders and non-responders. The most common non-hematologic adverse events (typically grade ≤2) were nausea (34.0%), fatigue (32.0%), and upper respiratory tract infections (28.9%). Infusion reactions (typically with first infusion and grade ≤2) occurred in 51.5% of patients. In conclusion, isatuximab is active and generally well tolerated in heavily pretreated RRMM, with greatest efficacy at doses ≥10 mg/kg.

Original languageEnglish (US)
JournalLeukemia
DOIs
StateAccepted/In press - 2020

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Mikhael, J., Richter, J., Vij, R., Cole, C., Zonder, J., Kaufman, J. L., Bensinger, W., Dimopoulos, M., Lendvai, N., Hari, P., Ocio, E. M., Gasparetto, C., Kumar, S., Oprea, C., Chiron, M., Brillac, C., Charpentier, E., San-Miguel, J., & Martin, T. (Accepted/In press). A dose-finding Phase 2 study of single agent isatuximab (anti-CD38 mAb) in relapsed/refractory multiple myeloma. Leukemia. https://doi.org/10.1038/s41375-020-0857-2