Dr Matous on the Benefit Derived from the IKEMA Trial in R/R Multiple Myeloma

Jeffrey V. Matous, MD, member physician, Colorado Blood Cancer Institute, clinical professor of medicine, University of Colorado, discusses the benefit derived from the phase 3 IKEMA trial (NCT03275285) in patients with relapsed/refractory multiple myeloma, highlighting the key factors to take into account when evaluating patients for relapsed/refractory disease within this treatment space.

The phase 3 trial evaluated the combination of isatuximab-irfc (Sarclisa), carfilzomib (Kyprolis), and dexamethasone, showing a 42% reduction in the risk of progression or death vs treatment with carfilzomib plus dexamethasone alone (HR, 0.58; 95.4% CI, 0.42-0.79). The median progression-free survival (PFS) was 35.7 months (95% CI, 25.8-44.0) for the triplet vs 19.2 months (95% CI, 15.8-25.0) for the doublet.

The isatuximab, carfilzomib, and dexamethasone triplet regimen is a potent approach in this treatment space, Matous says. There were significant PFS advantages derived in patients who received the triplet, representing an improvement over the doublet and other, older, standard-of-care regimens, Matous explains. Notably, this is a well-tolerated regimen which produced high and durable response rates in this patient population, he adds. He notes that this triplet is a beneficial regimen to consider for patients in this space, specifically if patients have not yet received carfilzomib or a recent CD-38 antibody.

Moreover, given the variety of options now available for patients with multiple myeloma, there are many factors to take into account when evaluating different approaches to take for patients with relapsed/refractory disease, Matous continues. When evaluating a patient with relapsed/refractory multiple myeloma, it is important to consider comorbidities, prior therapy, response to prior therapy, and the type of relapse, Matous says.

A history of neuropathy and financial concerns can also play a role in treatment decisions for patients, Matous adds. Processing all these factors and having discussions with patients are key to deciding on treatment beyond the first line of therapy, Matous concludes.