Isatuximab: ASH 2022 Phase 3 Ithaca Study
By Irene Ghobrial
At the annual meeting of the American Society of Hematology, we presented a number of abstracts, some of which focused on MGUS and smoldering multiple myeloma (ASH). Some preliminary data from the ITHACA phase 3 research were also disclosed. This research evaluated the usage of isatuximab, lenalidomide, and dexamethasone in patients with high-risk Smoldering Myeloma versus that of lenalidomide and dexamethasone. We are of the opinion that a score of 2220 (when taking into account M- spike, Light-chain, and bone marrow%) is clinically great; nonetheless, we are curious as to whether or not we can perform better. Both the microenvironment of the bone marrow and the peripheral circulation were investigated in order to gain a better understanding of the tumor cells. Next, we discussed the immunological single-cell sequencing findings from a separate clinical trial involving Elotuzumab, Lenalidomide, and Dexamethasone. These findings were obtained from a sample of patients who had received all three treatments. As part of one of the presentations, early safety results for patients who were randomly assigned to receive either LenDex or Isatuximab LenDex were discussed and presented.
Many of my colleagues have inquired as to why we should treat smoldering myeloma and what risk factors can assist us predict them so that we do not over- or under-treat patients. We also receive a lot of queries regarding selection, but of the clonal selection, if treating someone will lead to clonal selection and medication resistance.
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