Dr Maximilian Merz speaks to ecancer about the results of the phase 3 IKEMA study, which evaluated isatuximab + Kd vs Kd alone in the treatment of patients with RRMM.
Dr Merz reviews the IKEMA trial, which had a primary endpoint of PFS and key secondary endpoints that included CR, VGPR, and MRD-. He notes that the primary endpoint was met and the PFS benefit corresponded to a 47% reduction in the risk of disease progression or death (HR=0.531; 99% CI: 0.318, 0.889; P=0.0013).
Dr Merz goes on to describe the depth of response data, which saw 73% of patients achieving ≥VGPR and 40% achieving CR when isatuximab was added to Kd. For patients in the Kd arm, the response was 56% ≥VGPR and 28% CR. Additionally, he notes that nearly 1 in 3 patients achieved MRD- in IKEMA, characterising this as a very high rate for patients at first relapse.
Dr Merz explains that to maximise long-term outcomes, it is important to find treatments that deliver high rates of VGPR, CR, and MRD-, such as those seen in the IKEMA trial.
In IKEMA there were a greater number of grade ≥3 TEAEs with isatuximab + Kd vs Kd alone (77% vs 67%). Serious TEAEs were comparable between the two arms (59% vs 57%). Discontinuation rate of isatuximab + Kd was 8.5% vs 13.9% in the Kd arm alone.
After commenting on the safety profile of isatuximab + Kd, Dr Merz discusses his personal experience with prescribing isatuximab + Kd, highlighting the patient types that in his practice see the most benefit.
“In my own practice, it’s very important to emphasise that the combination of isatuximab with [a] proteasome inhibitor…is highly effective, especially in patients who…experience aggressive relapse, for example, on lenalidomide maintenance therapy,” Dr Merz concludes.
CR=complete response; Kd=carfilzomib and dexamethasone; MRD-=minimal residual disease negative/negativity; PFS=progression-free survival; VGPR=very good partial response.
ecancer's filming has been kindly supported by Sanofi through the ecancer Global Foundation.
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