The U.S. Food and Drug Administration (FDA) has approved a new combination therapy for adults newly diagnosed with multiple myeloma who are not eligible for autologous stem cell transplant. This approval marks an important advancement in treatment options for these patients.
Key Points
The FDA has approved isatuximab-irfc (Sarclisa) to be used in combination with three other drugs:
- Bortezomib
- Lenalidomide
- Dexamethasone
This four-drug combination is now available as a first-line treatment option for adults newly diagnosed with multiple myeloma who are not eligible for autologous stem cell transplant. This expands the indication of isatuximab which was previously approved as a combination therapy for patients with multiple myeloma who had received prior treatment.
Who Can Benefit
This therapy is specifically approved for:
- Adults with newly diagnosed multiple myeloma
- Patients who are not eligible for autologous stem cell transplant
- Individuals 80 years of age and younger
Efficacy
The approval was based on results from the IMROZ clinical trial, which showed:
- A 40% reduction in the risk of disease progression or death compared to the standard three-drug combination
- Median progression-free survival was not reached in the isatuximab group, while it was 54.3 months in the control group
Safety Profile
Common side effects (occurring in ≥20% of patients) included:
- Upper respiratory tract infection
- Diarrhea
- Fatigue
- Peripheral sensory neuropathy
- Pneumonia
What This Means for Patients
This approval provides a new, potentially more effective first-line treatment option for newly diagnosed multiple myeloma patients who cannot undergo stem cell transplants. The addition of isatuximab to the standard therapy appears to significantly improve outcomes. Patients with newly diagnosed multiple myeloma should discuss this treatment option with their oncologists to determine if it might be appropriate for their individual cases.
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References:
2. Facon T, Dimopoulos MA, Leleu XP, et al. IMROZ Study Group. Isatuximab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med. 2024 Jun 3.





