IMS 2025 | Anti-CD38–based quadruplet regimens for patients with transplant-ineligible multiple myeloma

The therapeutic revolution in multiple myeloma is continuing and we are going toward a switch from triplet to quadruplet in both the transplant eligible and not eligible patient. Particularly it’s changing the real end point for our patients in both the settings and we are aiming to obtain the deepest response as possible. Isatuximab, a new generation CD38 monoclonal antibody, is going to be integrating in both the transplant eligible and not eligible according to respectively GMMG clinical trial and IMROZ clinical trial together with the VRD. And the real end point of this treatment is to obtain the deepest response which correlates with MRD negativity, which is the best to obtain the optimal long-term response. This means that we can in some way withdraw the treatment in patients that obtain the best response according to the maintaining of a sustained MRD during maintenance. This is the new perspective starting from frontline if we want to run toward the cure in multiple myeloma. And I think that having a so potent backbone, we can really obtain this in a big part of the patient. Also for elderly population, we can in this way to personalize the treatment, particularly in fit patients in which we want to obtain an ambitious end point, we can give a quadruplet with a very tolerable monoclonal antibody that in this moment is intravenous, but in the next future could become subcutaneous according to what we have seen in the IRAKLIA trial in which OBI is a tool, a device that permits to administrate in a safe way through this button that is put on the abdomen subcutaneously isatuximab in a really fast, safe and tolerable way which can corellate also with the adherence of the patients. And we have also presented here in IMS 2025 in Toronto that about domestic administration of isatuximab through OBI and there is a satisfaction not only from the patient’s perspective, from their quality of life, but also from the healthcare staff because this is simple, this is fast and this is safer from all point of view. So this can help not only to optimize the outcome but also to optimize the hospital management of our patients in some way to spare resources and to optimize the patient journey in terms of access to the hospital and I think that in next future OBI could be something that can really change the history of our patients having the possibility to be used also in a really elderly population and helping also caregivers to in some way potentiate their relation with the myeloma patients without going to the hospital but only being in a domestic setting.

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