Isatuximab-irfc

(Sarclisa®)

Sarclisa®

Drug updated on 10/28/2024

Dosage FormInjection (intravenous; 100 mg/5 mL [20 mg/mL], 500 mg/25 mL [20 mg/mL])
Drug ClassCD38-directed cytolytic antibodies
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated in combination with pomalidomide and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least 2 prior therapies including lenalidomide and a proteasome inhibitor
  • Indicated in combination with carfilzomib and dexamethasone, for the treatment of adult patients with relapsed or refractory multiple myeloma who have received 1 to 3 prior lines of therapy
  • Indicated in combination with bortezomib, lenalidomide and dexamethasone, for the treatment of adult patients with newly diagnosed multiple myeloma who are not eligible for autologous stem cell transplant (ASCT).

Latest News

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Summary
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  • This summary is based on the review of 10 systematic review(s)/meta-analysis(es). [1-10]
  • In relapsed/refractory multiple myeloma (RRMM) patients, isatuximab combined with or IMiDs or PIs plus dexamethasone significantly improved progression-free survival (PFS) (HR (hazard ratio): 0.552) and overall survival (OS) (HR: 0.737) compared to IMiDs or PIs plus dexamethasone alone.
  • Isatuximab-based treatments showed higher overall response rates (ORR) compared to bortezomib/dexamethasone and lenalidomide/dexamethasone, with triple-drug regimens demonstrating the best probabilities for achieving superior ORRs.
  • In specific subgroups, isatuximab significantly improved HR: 0.552, 95% CI (confidence interval) = 0.461 to 0.659, 95% PI = 0.318 to 0.957 (PFS) in multiple myeloma patients with +1q, and in lenalidomide-refractory multiple myeloma, isatuximab/pomalidomide/dexamethasone showed superior efficacy compared to dexamethasone alone.
  • Isatuximab-based treatments were noted for producing the best treatment response quality for RRMM, with similar efficacy to daratumumab-based regimens.
  • In patients treated with isatuximab-based regimens combined with IMiDs or PIs plus dexamethasone, higher rates of hematologic adverse events such as thrombocytopenia and neutropenia, and nonhematologic adverse events like upper respiratory tract infections, pneumonia, bronchitis, dyspnea, diarrhea, pyrexia, and fatigue, were observed.
  • Infections, including pneumonia and upper respiratory tract infections, were more frequent in patients receiving anti-CD38 mAbs, including isatuximab, although there was no significant increased risk for varicella-zoster virus reactivation.
  • Neutropenia (32.1%) was the most common hematologic adverse event, while cough (43.3%) was the most frequent nonhematologic event in various isatuximab-based triplet regimens. Severe adverse events were more common in regimens including isatuximab, panobinostat, and pomalidomide.
  • Isatuximab demonstrated improved progression-free survival (PFS) in patients with relapsed/refractory multiple myeloma (RRMM), especially in subgroups with +1q chromosome abnormality and lenalidomide-refractory disease. These subgroups showed superior efficacy when treated with isatuximab-based regimens compared to standard therapies, highlighting its relevance in these specific populations.

Product Monograph / Prescribing Information

Document TitleYearSource
Sarclisa (isatuximab-irfc) Prescribing Information.2024Sanofi-Aventis U.S. LLC, Bridgewater, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Impact of Anti-CD38 Monoclonal Antibody Therapy on CD34+ Hematopoietic Stem Cell Mobilization, Collection, and Engraftment in Multiple Myeloma Patients-A Systematic Review2024Pharmaceuticals
Alterations in chromosome 1q in multiple myeloma randomized clinical trials: a systematic review2024Blood Cancer Journal
Efficacy and safety of anti-CD38 monoclonal antibodies in patients with relapsed/refractory multiple myeloma: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials2023Frontiers in Oncology
Comparative efficacy of novel-drugs combined therapeutic regimens on relapsed/refractory multiple myeloma: a network meta-analysis2023Hematology
Cumulative Incidence and Relative Risk of Infection in Patients With Multiple Myeloma Treated With Anti-CD38 Monoclonal Antibody-Based Regimens: A Systematic Review and Meta-analysis2022Open Forum Infectious Diseases
The efficacy and safety of triplet regimens based on pomalidomide and dexamethasone for treatment of relapsed/refractory multiple myeloma: a systematic review and meta-analysis2022European Review for Medical and Pharmacological Sciences
PK/PD modeling analysis for dosing regimen selection of isatuximab as single agent and in combination therapy in patients with multiple myeloma2021CPT: Pharmacometrics & Systems Pharmacology
A Systematic Review and Network Meta-analysis of Randomized Data on Efficacy of Novel Therapy Combinations in Patients with Lenalidomide-refractory Multiple Myeloma2021Clinical Lymphoma, Myeloma & Leukemia
Treatment of relapsed/refractory multiple myeloma in the bortezomib and lenalidomide era: a systematic review and network meta-analysis2021Annals of Hematology
Monoclonal antibodies in relapsed/refractory myeloma: updated evidence from clinical trials, real-life studies, and meta-analyses2020Expert Review of Hematology

Clinical Practice Guidelines