Isatuximab in combination with pomalidomide and dexamethasone may provide an effective treatment option in relapsed or refractory multiple myeloma, including difficult-to-treat subgroups of these patients, and may better maintain health-related quality of life (HRQoL).
The phase III ICARIA study demonstrated that isatuximab plus pomalidomide and dexamethasone (Isa-Pd) improves progression-free survival (PFS) in patients with relapsed or refractory multiple myeloma compared with pomalidomide plus dexamethasone (Pd) alone. This trend remained significant across several clinical subgroups.
Meletios Dimopoulos, MD, department of clinical therapeutics, National and Kapodistrian University of Athens (Greece), and colleagues designed a post-hoc analysis of ICARIA to determine HRQoL in patients receiving either therapy regimen. Researchers stratified patients by number of prior lines of therapy (more than three vs two to three) and by baseline creatinine clearance (less than 60mL/min/1.73m2 vs at least 60mL/min/1.73m2).
During ICARIA, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the EORTC Myeloma-specific module on day 1 of each 28-day treatment cycle until progression or unacceptable toxicity. Researchers designed a mixed model for repeated measures analyses to determine clinically meaningful changes in HRQoL.
Results of the post-hoc analysis were presented at the European Hematology Association (EHA) Annual Meeting (June 11-21, 2020).
In heavily pretreated patients (those with more than three prior lines of therapy; Isa-Pd, n = 47; Pd, n = 46), scores on the EORTC QLQ-C30 global health status/quality of life, EORTC QLQ-C30 pain, and EORTC Myeloma-specific module disease symptoms sections showed improved HRQoL in the Isa-Pd cohort compared with the Pd cohort. Additionally, physical and role function—as determined by EORTC QLQ-C30—were better maintained among patients receiving Isa-Pd.
Similarly, in patients with baseline renal impairment (creatinine clearance less than 60mL/min/1.73m2; Isa-Pd, n = 51; Pd, n = 42), scores on the EORTC QLQ-C30 global health status/quality of life, EORTC QLQ-C30 pain, and EORTC Myeloma-specific module disease symptoms sections showed improved HRQoL in the Isa-Pd cohort compared with the Pd cohort. Physical and role function were better maintained among patients receiving Isa-Pd, Dr Dimopoulos and colleagues added.
“Data from the ICARIA study suggest that in two difficult-to-treat subgroups of relapsed or refractory multiple myeloma patients (heavily pretreated and renally impaired patients), HRQoL was better maintained with Isa-Pd compared with Pd, based on key disease-relevant domains,” authors of the study concluded. “Isatuximab provides an important new treatment option in relapsed or refractory multiple myeloma, including difficult-to-treat subgroups of [such] patients.”—Zachary Bessette
