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

• Published in: Cancer Immunology, Immunotherapy : CII Immunotherapy : CII, 2024-05, Vol.73 (7), p.135, Article 135
• Main Authors: Shimazu, Yutaka, Kanda, Junya, Onda, Yoshiyuki, Fuchida, Shin-ichi, Ohta, Kensuke, Shimura, Yuji, Kosugi, Satoru, Yamamura, Ryosuke, Matsuda, Mitsuhiro, Hanamoto, Hitoshi, Adachi, Yoko, Anzai, Naoyuki, Hotta, Masaaki, Fukushima, Kentaro, Yagi, Hideo, Yoshihara, Satoshi, Tanaka, Yasuhiro, Takakuwa, Teruhito, Tanaka, Hirokazu, Shibayama, Hirohiko, Uoshima, Nobuhiko, Hosen, Naoki, Ito, Tomoki, Shimazaki, Chihiro, Matsumura, Itaru, Kuroda, Junya, Takaori-Kondo, Akifumi, Hino, Masayuki
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; CD38 antigen; Dexamethasone; Female; Humans; Immune status; Immunology; Leukocytes; Lymphocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Monocytes; Monocytes - immunology; Multiple myeloma; Multiple Myeloma - drug therapy; Multiple Myeloma - mortality; Multivariate analysis; Oncology; Prognosis; Retrospective Studies; Thalidomide - administration & dosage; Thalidomide - analogs & derivatives; Thalidomide - therapeutic use
• ISSN: 1432-0851; 0340-7004; 1432-0851
• DOI: 10.1007/s00262-024-03711-8

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