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IMS 2026 | Sequencing anti-CD38 antibodies in multiple myeloma
Albert Oriol, MD, PhD, Josep Carreras Leukaemia Research Institute, Barcelona, Spain, discusses how prior anti-CD38 antibody exposure should be considered when sequencing treatment for patients with multiple myeloma. He highlights the potential value of using alternative drug targets where available, while noting that re-exposure to an anti-CD38 antibody may remain an option when alternatives are limited, particularly after a longer treatment-free interval. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
We have to take into account not only sensitivity to the drug, but also the potential synergy between the drug and the drug that you combine with it. We are not using isatuximab alone, then it would be a matter of sensitivity to the drug, you are sensitive or you are not, but also we are combining that drug with different partners, probably with a triplet of a proteasome inhibitor and in it in the first line, maybe in the near future with a bispecific in the second line, maybe in some other combination in a later line...
We have to take into account not only sensitivity to the drug, but also the potential synergy between the drug and the drug that you combine with it. We are not using isatuximab alone, then it would be a matter of sensitivity to the drug, you are sensitive or you are not, but also we are combining that drug with different partners, probably with a triplet of a proteasome inhibitor and in it in the first line, maybe in the near future with a bispecific in the second line, maybe in some other combination in a later line. So, however, probably the message I would like to transmit is that re-exposure to a drug today, that we have that huge bulk of drugs with different mechanisms of action, with different targets, is probably not the best idea if you have an alternative. So my opinion, that’s not strictly the results of the trial, of course, but that’s how I extrapolate the findings of the trial to real life, is that if you have an alternative target, an alternative drug, this is much better than re-exposure to an anti-CD38 antibody. However, there are situations in which you do not have an alternative. In those situations you know that you can use the drug probably in a different combination it has used before and if you have if the possibility is there as far as possible or as late as possible after the exposure to the prior drug.
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