First experience with Isatuximab in newly diagnosed multiple myeloma patients. Case report

Multiple myeloma (MM) is a clonal malignant lymphoproliferative disease with a continuously recurrent course. There has been a significant evolution of approaches to MM therapy, including the use of new induction regimens with not three, but four drugs with different mechanisms of action. This approach applies to patients both eligible and non-eligible for autologous hematopoietic stem cell transplantation (auto-HSCT). Thus, an international randomized clinical trial has shown the efficacy and safety of adding isatuximab (an anti-CD38 monoclonal antibody) to triplet therapy in patients with newly diagnosed MM. The publication presents two authors’ clinical cases of the use of the Isa-VRd induction regimen in patients with newly diagnosed MM. In a 61-year-old patient to undergo auto-HSCT (transplantation is not scheduled as initial therapy), after 4 induction cycles with Isa-VRd regimen, the combined positron-emission and X-ray computed tomography showed a pronounced decrease in the metabolic activity of tumor tissue, a negative status of minimal residual disease was achieved with the sensitivity of the NGF (next generation flow) method of 10⁻⁵; currently, maintenance therapy is ongoing. In a 63-year-old patient, a candidate for auto-HSCT, after completing 3 cycles of induction therapy with Isa-VRd quadruplet and an auto-HSCT, strict complete remission of the disease was achieved according to the International Myeloma Working Group (IMWG) 2016 criteria. Maintenance therapy is currently ongoing.