isatuximab at a glance
Medicine class
Anti-CD38 IgG1 monoclonal antibody
Usual role
Combination treatment for newly diagnosed or previously treated multiple myeloma in adults
How it is given
By intravenous infusion or injection under the skin, administered by a healthcare professional
Important patient card
Carry the isatuximab Patient Card during treatment and for at least 6 months afterwards because blood-matching tests can be affected
What is isatuximab used for?
Licensed uses are combination treatments for adults with multiple myeloma.
With pomalidomide and dexamethasone for relapsed and refractory disease after specified previous treatments and progression on the latest treatment.
With carfilzomib and dexamethasone after at least one previous treatment.
With bortezomib, lenalidomide and dexamethasone for newly diagnosed disease when autologous stem-cell transplantation is unsuitable.
With bortezomib, lenalidomide and dexamethasone as induction treatment when autologous stem-cell transplantation is planned.
How does isatuximab work?
Isatuximab binds to CD38, a protein highly expressed on multiple myeloma cells. This promotes immune-mediated killing and phagocytosis, can activate complement and direct cell-death pathways, and inhibits CD38 enzyme activity.
isatuximab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
Injection
Route: Parenteral
Strengths: 1400 mg
How to take isatuximab
Isatuximab is prepared and administered by trained healthcare professionals; it is not taken by mouth. Medicines are given beforehand to reduce administration reactions.
The intravenous formulation is diluted and infused in a setting with resuscitation facilities.
The subcutaneous formulation is injected into the abdomen; sites should be rotated and damaged, tender or inflamed skin avoided.
isatuximab side effects
Common or expected effects
- Administration reactions, including breathlessness, cough, chills, nausea or fever
- Diarrhoea, constipation, nausea or vomiting
- Fatigue, weakness, back or joint pain
- Respiratory infections, including bronchitis and pneumonia
- Reduced neutrophils, platelets or red blood cells
- Breathlessness, cough or high blood pressure
- Local injection-site reactions with the subcutaneous formulation
Get urgent medical advice
- Severe allergic or administration reaction, including anaphylaxis
- Serious infection or fever with a low neutrophil count
- Pneumonia or other severe respiratory infection
- Tumour lysis syndrome
- Severe bleeding associated with low platelets
- New or worsening cardiac symptoms, particularly with carfilzomib-containing treatment
- Second primary malignancy
isatuximab in pregnancy
Isatuximab is not recommended during pregnancy because human data are unavailable and IgG1 antibodies can cross the placenta after the first trimester. People who could become pregnant should discuss effective contraception with their specialist and use it during treatment and for 7 months after treatment ends.
isatuximab while breastfeeding
It is unknown whether isatuximab enters human milk. A risk cannot be excluded shortly after birth, so the specialist and patient must weigh the benefits of breastfeeding against the need for treatment; use during later breastfeeding may be considered if clinically necessary.
isatuximab interactions
No clinically important pharmacokinetic interaction with the licensed combination partners is expected. The treatment team should still review all prescribed, non-prescription and herbal products.
Pomalidomide, carfilzomib, bortezomib and lenalidomide
Coadministration is not expected to alter the pharmacokinetics of isatuximab or these combination partners.
Common questions about isatuximab
Answers are fully visible for fast scanning and source review.
Is isatuximab chemotherapy?
It is a targeted monoclonal antibody rather than conventional cytotoxic chemotherapy, although it is given with other anti-myeloma treatments.
What cancer does isatuximab treat?
It is licensed for selected adults with multiple myeloma, including newly diagnosed and previously treated disease.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.