By synergizing real-world pharmacovigilance with transcriptomic data, this study delineates novel clinical AE signals and mechanistic insights linking CD38-driven immunometabolic dysregulation to isatuximab toxicity. These findings underscore the imperative for vigilant monitoring and tailored therapeutic strategies to mitigate risks of immune dysfunction, informing both clinical practice and future biomarker-driven interventions.
Treatment regimens comprised lenalidomide (n = 36) or thalidomide (n = 15) with daratumumab, and pomalidomide (n = 2) with isatuximab. Most patients (n = 38) received frontline therapy, and all were given thromboprophylaxis according to guidelines, mainly aspirin (73%)...Given the limited number of patients and thrombotic events, and the cytokine data available for only two VTE cases, these associations should be regarded as exploratory and interpreted with caution. Overall, these exploratory findings warrant validation in larger, independent cohorts and may help generate hypotheses on how inflammatory signatures influence thrombotic risk and prophylaxis efficacy in MM patients receiving IMiD/anti-CD38-based regimens.
The effects of IMiDs (pomalidomide, lenalidomide) on CD38 expression and isatuximab-induced apoptosis, either alone or in combination with IMiDs, were also examined. Additionally, both antibodies effectively inhibited MM cell migration and significantly reduced cell adhesion. Their non-competitive binding and shared impact on cell dynamics suggest opportunities for optimizing treatment strategies through combinatorial or sequential approaches in MM therapy.
Novel CT-based quantification approaches for assessing BM involvement in the appendicular skeleton correlate with key clinical and PET parameters in MM. As low-dose, standardized techniques, they show promise for inclusion in MM imaging protocols, potentially enhancing assessment of disease extent and treatment response.