학술논문
The lymphocyte/monocyte ratio predicts the efficacy of isatuximab plus pomalidomide in multiple myeloma patients
Document Type
Original Paper
Author
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
Source
Cancer Immunology, Immunotherapy. 73(7)
Subject
Language
English
ISSN
1432-0851
Abstract
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 (< 6), and no use of prior daratumumab treatment. The OS under the Isa-PD regimen was longer in patients with higher white blood cell counts (WBC counts ≥ 3000/μL) and higher LMR. The PFS under the Isa-D regimen was longer in patients with fewer prior treatment regimens in univariate analysis, but no parameters were correlated with PFS/OS under the Isa-KD regimen.Conclusion: We found that the patients with higher LMR (≥ 4) could obtain longer PFS and OS under the Isa-PD regimen. Other cohort studies of isatuximab treatment might be necessary to substantiate our results.