IKEMA Study in R/R Multiple Myeloma

EP: 1.Clinical Case 1: 69-Year-Old Man With Multiple Myeloma (MM)

EP: 2.Overview of Biochemical vs Clinical Relapse in Myeloma

EP: 3.Multiple Myeloma: Treatment Options for First Relapse

EP: 4.Updates From the CANDOR Study in R/R Multiple Myeloma

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EP: 5.IKEMA Study in R/R Multiple Myeloma

EP: 6.Selecting the Appropriate Treatment Regimen and Assessing Response at First Relapse in Myeloma

EP: 7.Clinical Case 2: 59-Year-Old Woman With R/R MM

EP: 8.Role of Belantamab Mafodotin in R/R MM

EP: 9.Updates From ASH 2021 for Belantamab-based Combinations in Myeloma

EP: 10.Managing AEs With Belantamab Mafodotin in Relapsed/Refractory Myeloma

EP: 11.Ongoing Trials of Belantamab Mafodotin in MM and Optimal Position in Treatment Landscape

EP: 12.Treatment Options for Patients Progressing on Belantamab Mafodotin in MM

EP: 13.Clinical Case 3: A 56-Year-Old Man With Multiple Myeloma

EP: 14.CARTITUDE-1 Study in Relapsed/Refractory Multiple Myeloma

EP: 15.KarMMa Study in Relapsed/Refractory Multiple Myeloma

EP: 16.Novel CAR-T Therapies in Relapsed/Refractory MM and Identifying the Right Patients for CAR-T Therapies

EP: 17.Role of CAR T Therapies in Newly Diagnosed Multiple Myeloma

EP: 18.Unmet Needs in the Management of Multiple Myeloma

Nina Shah, MD: Ola, in thinking about different options, we’ve talked about DKd [daratumumab, carfilzomib, dexamethasone], but what about the IKEMA trial using isatuximab? Can you summarize that trial briefly? Talk about where you might use isatuximab, its toxicities, and the outcomes that are in a way still pending.

Ola Landgren, MD, PhD: The CANDOR trial uses carfilzomib with daratumumab-dexamethasone. This other study, IKEMA, somewhat mirrors the design. It’s carfilzomib-dexamethasone, but instead of daratumumab, we have isatuximab, the other CD38-targeted monoclonal antibody that we have in multiple myeloma. The dosing for carfilzomib in this study is the same as in the CANDOR study. It’s twice a week. The difference between the antibodies from a clinical point of view is that the isatuximab is still an infusional drug. It’s an IV [intravenous] drug. Daratumumab is both IV and subcutaneous. It was developed in CANDOR as IV but has been updated as also subcutaneous.

The IKEMA regimen is the alternative. It’s FDA approved. All the clinicians are wondering if you could go from CANDOR to IKEMA or from IKEMA to CANDOR. How does that work? We don’t have any data to show sequence, which is similar to most other regimens, where we have these same questions. My gut feeling is that it’s probably a good idea to go to some other therapy in between, because after all, they target the similar thing, the CD38 molecule. We can look at these antibodies, and they’re slightly different. The mechanisms of action aren’t identical. The molecular details of these drugs aren’t identical. But in my experience, the clinical difference isn’t that strong, so I’d throw another therapy in between. As for the adverse effect profile, they’re very similar to each other in a very simple way.

Nina Shah, MD: Yes, and it’s sometimes hard to know the true differences between these 2 studies because they’re done separately. It’s hard to compare, and the patients might be a bit different between the 2. We know that the median PFS [progression-free survival] of IKEMA is still pending for the isatuximab-carfilzomib-dexamethasone arm, so we’ll see what happens. But the control arm also did very well. You brought up a good point about prior CD38 therapy.

Transcript Edited for Clarity