Dr Cesar Rodriguez, affiliated with Mount Sinai in New York, presents a research study examining the impact of isatuximab (Isa) on the occurrence of hypogammaglobulinemia (HGG) and the concomitant risk of infection in patients with R/R MM, whether administered as a standalone agent or in combination.
The study compiled data from all investigations involving Isa as a monotherapy, including results from the ICARIA-MM and IKEMA studies. These datasets were systematically analyzed to assess the incidence of HGG in the control group as compared to patients treated with Isa.
Upon incorporating Isa into therapeutic regimens, there was observed HGG, yet this did not necessarily result in a heightened susceptibility to infections. Notably, the correlation between infection rates in these therapeutic interventions was more closely associated with neutropenia rather than HGG.
This observation is substantiated by the discovery that the occurrence of grade 3 and grade 4 infections did not significantly escalate in the Isa treatment groups. Remarkably, this finding persists despite the absence of prophylactic IVIG use, a preventive measure currently employed with anti-CD38 agents and bispecific T-cell engagers to mitigate infection risks.
In conclusion, our study underscores the importance of directing attention toward neutropenia in combination therapies rather than exclusively focusing on HGG, which emerges as the primary driver of infections in anti-CD38 and combination therapy contexts.
Rodriguez C, ASH2023. #1980
With the educational support of: