Renal impairment (RI) is common in patients with multiple myeloma (MM) and new therapies that can improve renal function are needed. The Phase 3 IKEMA study (NCT03275285) investigated isatuximab (Isa) with carfilzomib and dexamethasone (Kd) vs Kd in relapsed MM. This subgroup analysis examined results from patients with RI, defined as estimated glomerular filtration rate <60 mL/min/1.73 m². Addition of Isa prolonged PFS in patients with RI (hazard ratio, 0.27; 95% CI, 0.11–0.66; median PFS not reached for Isa-Kd vs 13.4 months for Kd [20.8- month follow-up]). Complete renal responses occurred more frequently with Isa-Kd (52.0%) vs Kd (30.8%) and were durable in 32.0% vs 7.7% of patients, respectively. Treatment exposure was longer with Isa-Kd, with median number of started cycles and median duration of exposure of 20 vs 9 cycles and 81.0 vs 35.7 weeks for Isa-Kd vs Kd, respectively. Among patients with RI, the incidence of patients with grade ≥3 treatment-emergent adverse events was similar between the two arms (79.1% in Isa-Kd vs 77.8% in Kd). In summary, the addition of Isa to Kd improved clinical outcomes with a manageable safety profile in patients with RI, consistent with the benefit observed in the overall IKEMA study population.
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