Isatuximab is a monoclonal antibody targeting the transmembrane receptor and ectoenzyme CD38 , a protein highly expressed on hematological malignant cells, including those in multiple myeloma (MM).

Isatuximab has antitumor activity via multiple biological mechanisms, including antibody-dependent cellular-mediated cytotoxicity, complement-dependent cytotoxicity, antibody-dependent cellular phagocytosis, and direct induction of apoptosis without crosslinking.

Isatuximab also directly inhibits CD38 ectoenzyme activity, which is implicated in many cellular functions.

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An in-vitro study shows that the combination of Isatuximab with Pomalidomide (an immunomodulatory drug) results in greater direct toxicity and lysis of CD38 multiple myeloma cells by effector cells compared with Isatuximab alone[2].

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1. Dhillon S. Isatuximab: First Approval [published correction appears in Drugs. 2020 May 23;:]. Drugs. 2020;80(9):905-912.2. Attal M, et al. Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study [published correction appears in Lancet. 2019 Dec 7;394(10214):2072]. Lancet. 2019;394(10214):2096-2107.

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