The lymphocyte/monocyte ratio predicts the efficacy of isatuximab plus pomalidomide in multiple myeloma patients.

Humans Multiple Myeloma / drug therapy Female Male Thalidomide / analogs & derivatives Aged Middle Aged Retrospective Studies Antineoplastic Combined Chemotherapy Protocols / therapeutic use Lymphocytes Monocytes / immunology Antibodies, Monoclonal, Humanized / therapeutic use Adult Aged, 80 and over Prognosis

Isatuximab Lymphocyte/monocyte ratio Multiple myeloma Predictive markers

Journal

Cancer immunology, immunotherapy : CII

ISSN: 1432-0851

Titre abrégé: Cancer Immunol Immunother

Pays: Germany

ID NLM: 8605732

Informations de publication

Date de publication:
17 May 2024

Historique:

received: 14 02 2024

accepted: 20 04 2024

medline: 17 5 2024

pubmed: 17 5 2024

entrez: 17 5 2024

Statut: epublish

Résumé

Isatuximab, an anti-CD38 antibody, has been widely used in treatments for patients with relapsed/refractory multiple myeloma (MM). Despite its high efficacy, not all patients achieve a lasting therapeutic response with isatuximab. We tried to identify biomarkers to predict the effectiveness of isatuximab by focusing on the host's immune status before treatment. We retrospectively analyzed the cases of 134 relapsed/refractory MM patients in the Kansai Myeloma Forum database who had received only a first isatuximab treatment. Among the 134 patients, an isatuximab, pomalidomide and dexamethasone (Isa-PD) regimen, isatuximab, carfilzomib and dexamethasone (Isa-KD) regimen and isatuximab and/or dexamethasone (Isa-D) regimen were used in 112, 15 and 7 patients, respectively. The median age at treatment, number of prior treatment regimens, and progression-free survival (PFS) were 71, 6, and 6.54 months, respectively. Multivariate analysis showed that the PFS under the Isa-PD regimen was longer in patients with higher lymphocyte/monocyte ratio (LMR ≥ 4), fewer prior treatment regimens (< 6), and no use of prior daratumumab treatment. The OS under the Isa-PD regimen was longer in patients with higher white blood cell counts (WBC counts ≥ 3000/μL) and higher LMR. The PFS under the Isa-D regimen was longer in patients with fewer prior treatment regimens in univariate analysis, but no parameters were correlated with PFS/OS under the Isa-KD regimen. We found that the patients with higher LMR (≥ 4) could obtain longer PFS and OS under the Isa-PD regimen. Other cohort studies of isatuximab treatment might be necessary to substantiate our results.

Sections du résumé

BACKGROUND BACKGROUND

OBJECTIVE OBJECTIVE

We tried to identify biomarkers to predict the effectiveness of isatuximab by focusing on the host's immune status before treatment.

METHODS METHODS

We retrospectively analyzed the cases of 134 relapsed/refractory MM patients in the Kansai Myeloma Forum database who had received only a first isatuximab treatment.

RESULTS RESULTS

Among the 134 patients, an isatuximab, pomalidomide and dexamethasone (Isa-PD) regimen, isatuximab, carfilzomib and dexamethasone (Isa-KD) regimen and isatuximab and/or dexamethasone (Isa-D) regimen were used in 112, 15 and 7 patients, respectively. The median age at treatment, number of prior treatment regimens, and progression-free survival (PFS) were 71, 6, and 6.54 months, respectively. Multivariate analysis showed that the PFS under the Isa-PD regimen was longer in patients with higher lymphocyte/monocyte ratio (LMR ≥ 4), fewer prior treatment regimens (< 6), and no use of prior daratumumab treatment. The OS under the Isa-PD regimen was longer in patients with higher white blood cell counts (WBC counts ≥ 3000/μL) and higher LMR. The PFS under the Isa-D regimen was longer in patients with fewer prior treatment regimens in univariate analysis, but no parameters were correlated with PFS/OS under the Isa-KD regimen.

CONCLUSION CONCLUSIONS

We found that the patients with higher LMR (≥ 4) could obtain longer PFS and OS under the Isa-PD regimen. Other cohort studies of isatuximab treatment might be necessary to substantiate our results.

Identifiants

DOI: 10.1007/s00262-024-03711-8 PMID: 38758239

pubmed: 38758239

doi: 10.1007/s00262-024-03711-8

pii: 10.1007/s00262-024-03711-8

doi:

Substances chimiques

pomalidomide 0

isatuximab 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

135

Informations de copyright

Références

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