Mednet Logo
HomeHematologyQuestion

For a patient with MM progressing on a daratumumab-based regimen, is it preferable to entirely switch drug class or is another monoclonal antibody such as isatuximab an acceptable next step?

5
5 Answers
Mednet Member
Mednet Member
Medical Oncology · Memorial Sloan Kettering Cancer Center

Class switch approach appears to give better disease control, isatuximab does not have activity in daratumumab refractory patients (Mikhael et al., PMID 33980831).

Register or Sign In to see full answer

Mednet Member
Mednet Member
Medical Oncology · University of Michigan

I recommend switching drug classes after progression on daratumumab.

Isatuximab, like daratumumab, is a monoclonal antibody against CD38. It has been shown to be ineffective after progression on daratumumab. Mikhael et al, PMID 33980831. While elotuzumab is a monoclonal antibody with a different targ...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Medical Oncology · University of Washington, Fred Hutchinson Cancer Research Center

Agreed with the above two answers. In case the converse question ever comes up (daratumumab in isatuximab-exposed patients), it's also worth noting that a recent update from the ICARIA-MM trial at the 2021 ASCO meeting showed a 14% overall response rate (ORR) to daratumumab monotherapy and 31% ORR w...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Medical Oncology · OhioHealth

From personal experience, and also publication noted earlier, no benefit with Isatuximab after Daratumumab or possibly vice versa. May have some benefit if >6 mos since last exposure to either drug. Options here:

  • If on daratumumab alone and monthly, can actually change back to every 2 weeks and add...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

Unfortunately, optimal treatment after daratumumab failure remains unknown, because most of the phase III trials including pomalidomide/dexamethasone or carfilzomib/dexamethasone backbones did not enroll patients refractory to anti-CD38 monoclonal antibodies. In patients not previously treated with ...

Register or Sign In to see full answer

For a patient with MM progressing on a daratumumab-based regimen, is it preferable to entirely switch drug class or is another monoclonal antibody such as isatuximab an acceptable next step? | Mednet