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Isatuximab/Pomalidomide/Dexamethasone in Myeloma: Is Prescreening Patients for Biomarkers Warranted?

By: Kayci Reyer
Posted: Thursday, April 15, 2021

According to research presented in Blood Cancer Journal, there appears to be no meaningful association between tumor response and specific baseline biomarkers in patients with relapsed or refractory multiple myeloma treated with isatuximab/pomalidomide/dexamethasone. Joseph Mikhael, MD, of the City of Hope Cancer Center, Phoenix, and colleagues suggest that prescreening patients for these biomarkers may be unwarranted.

The exploratory analysis compiled patient data from two previous clinical studies: one dose-escalation study of the triplet regimen and one comparative study of the triplet regimen versus pomalidomide plus dexamethasone. The analysis sought to determine whether biomarkers including CD38 receptor density on bone marrow plasma cells, Fc immunoglobulin receptor (FCGR3A) genotype, bone marrow, and peripheral blood immunophenotypes are prognostic factors in treatment with this three-drug combination.

No clear association between Fc polymorphism or increased median CD38 receptor density in patients responding to isatuximab/pomalidomide/dexamethasone treatment and treatment outcome was noted. No meaningful relationship between immune cell subsets (natural killer cells, T cells, B cells) or immunophenotyping and treatment response was identified. Whether a patient responded to isatuximab-based treatment did not appear to affect tested immune biomarkers in cell samples of peripheral blood or bone marrow plasma. The triplet regimen was determined to provide a reliable benefit to patients with relapsed or refractory multiple myeloma.

“Limitations of the current study include the small subsets of patients evaluated for some of the included analyses,” the study authors acknowledged.

Disclosure: For full disclosures of the study authors, visit nature.com.



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