Isatuximab for the treatment of multiple myeloma

Isatuximab is an IgG1 monoclonal antibody targeting CD38 that has received regulatory approval in combination regimens for patients with relapsed/refractory multiple myeloma. CD38 is an antigen with high surface expression on multiple myeloma cells. While daratumumab holds most of the market share for this drug class, isatuximab offers several unique aspects including a mechanism of action that may involve more direct myeloma-cell inhibition and killing and less reliance on cross-linking and immune effector cells, as well as subgroup data from pivotal trials showing notable efficacy in populations with renal impairment, high-risk cytogenetics and the elderly. While the administration of the drug remains intravenous, studies of fixed-volume infusion and rapid infusion may improve drug administration convenience. Ongoing studies are examining isatuximab in combination with other immune therapies and cellular therapies, conventional chemotherapy and across other disease entities.