Isatuximab, pomalidomide and dexamethasone in the treatment of relapsed/refractory multiple myeloma in real clinical practice

Aim. To evaluate the efficacy and tolerability of the combination of isatuximab, pomalidomide, dexamethasone (IsaPd) in the treatment of relapsed refractory multiple myeloma (RRMM) in a real clinical practice. Materials and methods. The retrospective study included 60 patients (28 men and 32 women aged 39 to 81 years, median age 64 years) with refractory and relapsed forms of MM. All patients received isatuximab intravenously at a dose of 10 mg/kg (weekly during cycle 1 and once every 2 weeks in subsequent cycles), pomalidomide 4 mg orally once a day from day 1 to day 21 of the course, and dexamethasone weekly at a dose of 40 mg (if age 75 years) or 20 mg (if age ≥75 years). IsaPd courses of 28 days were administered until RRMM progression or unacceptable toxicity. Results. The median follow-up was 17.3 months (range 2–34 months) and the median duration of response was 16.3 months (range 2–27 months). The overall response rate was 65.0%. Complete response was achieved in 5 patients (8.3%), very good partial response in 18 (30%), partial response in 16 (26.7%), minimal response in 5 (8.3%), stabilization in 3 (5%), and progression in 11 (18.3%). Median progression-free survival was 16.1 months (95% confidence interval 9.0–23.2 months), 12-month progression-free survival was 58.0%. Median overall survival was not reached, 12-month overall survival was 72.9%. The most common adverse events with this regimen were upper respiratory tract infections (32%) and neutropenia (35%). Conclusion. The IsaPd combination demonstrates a favorable toxicity profile and high efficacy in patients with RRMM in the real clinical practice setting.