Researchers of a multicenter real-world analysis assessed the efficacy of isatuximab, pomalidomide, and dexamethasone (IsaPd) in 51 patients with multiple myeloma (MM) who were refractory to daratumumab (Dara-R). The study found an overall response rate (ORR) of 56.9%, with notable responses including stringent complete response in 3 patients, complete response (CR) in 4, and very good partial response in 7. Despite being heavily pretreated, the patient characteristics such as age, number of prior therapies, triple-class refractoriness, and time from Dara refractoriness to IsaPd initiation did not significantly affect response rates.

The median progression-free survival (PFS) was 5.8 months, with a 12-month PFS probability of 30.6%. hemoglobin (Hb) levels were a key predictor of PFS, with patients having Hb < 11.8 g/L showing a 3.5-fold increased risk of progression compared to those with higher Hb. The median overall survival (OS) was 21.0 months, with a 12-month OS probability of 63.4%. Lower Hb levels (< 11 g/L) were linked to a tenfold increased risk of mortality. Additionally, patients with high-risk cytogenetic abnormalities demonstrated a nearly tenfold increased risk of disease progression. The study concluded that IsaPd offers a meaningful option for Dara-R patients, but the modest PFS highlights the need for novel combination therapies.

Reference: Martino EA, Derudas D, Rossi E, et al. Efficacy and Prognostic Indicators of Isatuximab, Pomalidomide, and Dexamethasone (IsaPd) in Daratumumab-Refractory Multiple Myeloma Patients: A Multicenter Real-World Study. Hematol Oncol. 2025;43(2):e70042. doi: 10.1002/hon.70042.