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Isatuximab SAR650984

Phase 3

Plasma Cell Myeloma | Small molecule | Oncology |Sanofi|Last Updated: May 4, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedACTIVE_CONTROLLEDDMCBiomarker
Total Trials7
Total Enrollment1,424
FDA Designations
No designations recorded
Clinical Trials (7)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04270409Isatuximab in Combination With Lenalidomide and Dexamethasone in High-risk Smoldering Multiple MyelomaPHASE3 ACTIVE NOT_RECRUITING 337Jun 16, 2020Oct 21, 2033Dec 12, 2025105 United States, Australia +22
NCT03319667A Study to Investigate the Clinical Benefit of Isatuximab in Combination With Bortezomib, Lenalidomide and Dexamethasone in Adults With Newly Diagnosed Multiple Myeloma Not Eligible for TransplantPHASE3 ACTIVE NOT_RECRUITING 475Dec 7, 2017Jun 30, 2027May 4, 2026104 United States, Australia +19
NCT03275285Multinational Clinical Study Comparing Isatuximab, Carfilzomib And Dexamethasone To Carfilzomib And Dexamethasone In Relapse And/Or Refractory Multiple Myeloma PatientsPHASE3 COMPLETED 302Oct 25, 2017Jan 3, 2025Feb 9, 202670 United States, Australia +14
NCT03194867Isatuximab in Combination With Cemiplimab in Relapsed/Refractory Multiple Myeloma (RRMM) PatientsPHASE1 COMPLETED 109Feb 21, 2018Apr 5, 2023Jun 14, 202430 United States, Australia +8
NCT02513186Study of Isatuximab Combined With Bortezomib + Cyclophosphamide + Dexamethasone (VCD) and Bortezomib + Lenalidomide + Dexamethasone (VRD) in Newly Diagnosed Multiple Myeloma (MM) Non Eligible for Transplant or No Intent for Immediate TransplantationPHASE1 COMPLETED 90Sep 30, 2015Jan 22, 2024Jan 29, 202412 France, Germany +2
NCT02283775SAR650984, Pomalidomide and Dexamethasone in Combination in RRMM PatientsPHASE1 COMPLETED 54May 15, 2015May 26, 2021Jul 9, 202113 United States
NCT01749969SAR650984 (Isatuximab), Lenalidomide, and Dexamethasone in Combination in RRMM PatientsPHASE1 COMPLETED 57Feb 6, 2013Jun 20, 2023Jul 13, 20235 United States
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Study Endpoints
Primary Endpoints
Number of participants with Treatment-emergent adverse events (AEs) and serious adverse events- Safety Run-in Part
Up to approximately 63 months
Plasma concentration of isatuximab during the treatment period - Safety Run-in Part
After first infusion from Cycle 1 Day 1 to Day 28 in safety run-in part
Receptor density/receptor occupancy Safety Run-in Part
Baseline to Cycle 2 Day 1 (each cycle is 28 days)

Change in CD38 receptor occupancy from baseline

Progression-free survival (PFS) Randomized Phase 3 Part
Up to approximately 114 months

PFS defined as the time from randomization to MM (SLiM CRAB criteria) or other related conditions based on independent review committee (IRC) assessment according to 2014 International Myeloma Working Group (IMWG) criteria or death from any cause, whichever happens first

Progression free survival (PFS)
Up to approximately 100 months after the First Participant In (FPI)

Defined as the time from the date of randomization to the date of first documentation of progression disease (PD) as determined by the independent review committee (IRC) or the date of death from any cause, whichever occurs first.

Progression Free Survival (PFS) As Determined by Independent Response Committee (IRC): Primary Analysis
From randomization until the primary analysis data cut-off date of 7 Feb 2020 (median duration of follow-up was 20.73 months)

Time (in months) from randomization to date of 1st documentation of progressive disease (PD)/date of death from any cause, whichever comes 1st. If PD \& death are not observed before cut-off date/date of initiation of further anti-myeloma treatment, PFS was censored at date of last valid disease assessment not showing PD performed prior to initiation of further anti-myeloma treatment/cut-off date, whichever comes 1st. PD(IMWG criteria):any 1 of following:Increase(inc) of \>=25% in serum M-component from nadir; serum M component inc \>=1 g/dL in 2 consecutive assessment, if starting M component \>=5 g/dL; and/or inc of \>=25% in urine M-component from nadir and/or development of new bone lesion/soft tissue extramedullary disease/inc \>=50% from nadir in sum of perpendicular diameters of existing soft tissue extramedullary disease lesion if \>1 lesion/ \>=50% increase in longest diameter of previous soft tissue extramedullary disease lesion \>1 cm in short axis. Estimated by Kaplan-Meier method.

Progression Free Survival as Determined by Independent Response Committee: [Event Censored if Occurred >8 Weeks From Last Disease Assessment]: Primary Analysis
From randomization until the primary analysis data cut-off date of 7 Feb 2020 (the median duration of follow-up was 20.73 months)

Time (in months) from randomization to date of 1st PD documentation/death date, whichever is 1st. If PD \& death not observed before cut-off date/date of further anti-myeloma treatment initiation, PFS censored at date of last valid disease assessment not showing PD performed prior to initiation of further anti-myeloma treatment/cut-off date, whichever was 1st. Progression/deaths occurring \>8 weeks after last disease assessment censored at earliest date of last disease assessment without evidence of progression before initiation of new anti-myeloma treatment \& cut-off date. PD (IMWG criteria): meeting any 1: Inc \>=25% in Serum M-component from nadir; serum M component inc \>=1 g/dL in 2 consecutive assessment, if starting M component \>=5 g/dL; and/or inc \>=25% in Urine M-component from nadir and/or development of new bone lesion/soft tissue extramedullary disease/inc \>=50% from nadir in sum of perpendicular diameters of existing soft tissue extramedullary disease lesion \>1 cm short axis.

Progression Free Survival as Determined by Independent Response Committee: Final Analysis
From randomization until the final analysis data cut-off date of 14 January 2022 (the median duration of follow-up was 43.96 months)

PFS: time (in months) from randomization to date of first documentation of PD or date of death from any cause, whichever comes first. If PD and death are not observed before analysis cut-off date or date of initiation of further anti-myeloma treatment, PFS was censored at date of last valid disease assessment or analysis cut-off date, whichever comes first. PD as per IMWG criteria: any 1 of following: Inc of \>=25% in Serum M-component from nadir; serum M component increase \>=1 g/dL in 2 consecutive assessment, if starting M component was \>=5 g/dL; and/or inc of \>=25% in Urine M-component from nadir and/or development of new bone lesion/soft tissue extramedullary disease/inc \>=50% from nadir in sum of perpendicular diameters of existing soft tissue extramedullary disease lesion if \>1 lesion/ \>=50% inc in longest diameter of previous soft tissue extramedullary disease lesion \>1 cm in short axis. PFS estimated by Kaplan-Meier method.

Progression Free Survival as Determined by Independent Response Committee [Event Censored if Occurred >8 Weeks From Last Disease Assessment]: Final Analysis
From randomization until the final analysis data cut-off date of 14 Jan 2022 (the median duration of follow-up was 43.96 months)

Time (in months) from randomization to date of 1st documentation of PD/date of death from any cause, whichever comes 1st. If PD \& death are not observed before cut-off date/date of initiation of further anti-myeloma treatment, PFS was censored at date of last valid disease assessment not showing PD/cut-off date, whichever comes 1st. Progressions/deaths occurring \>8 weeks after last disease assessment were censored at earliest date of last valid disease assessment not showing PD before initiation of further anti-myeloma treatment \& cut-off date. PD (per IMWG criteria): meeting any 1 criteria: Inc of \>=25% in serum M-component from nadir; serum M component inc \>=1 g/dL in 2 consecutive assessment, if starting M component was \>=5 g/dL; and/or inc of \>=25% in urine M-component from nadir and/or development of new bone lesion/soft tissue extramedullary disease/inc \>=50% from nadir in sum of perpendicular diameters of existing soft tissue extramedullary disease lesion \>1 cm in short axis.

Phase 1: Number of Participants With Dose-Limiting Toxicities (DLTs)
Cycle 1 Day 1 to Day 28

Potential DLTs were defined as the occurrence of any of the following adverse reactions at first treatment cycle, unless due to disease progression or obviously unrelated cause: Hematological DLTs: Grade(G) 4 neutropenia (N) for more than 7 consecutive days, G3 to G4 N complicated by fever (temperature greater than or equal to \[\>=\] 38.5 degree Celsius on more than 1 occasion) or microbiologically/radiographically documented infection, G3 to G4 thrombocytopenia associated with clinically significant bleeding requiring clinical intervention or Non-hematological DLTs: G4 non-hematologic AE, G\>=2 uveitis, G3 non-hematological AE lasting greater than (\>)3 days despite optimal care support, delay in initiation of Cycle 2 \>14 days due to treatment related laboratory abnormalities/AE. Any other AE that the investigator/study committee deemed to be dose-limiting, regardless of grade, was also considered as DLT.

Phase 1 and Phase 2: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs)
TEAEs were collected from the first dose up to 30 days after the last dose of study treatment, approximately 50 months

An AE was defined as any untoward medical occurrence in a participant or clinical investigation participant administered with a pharmaceutical product and which did not necessarily have a causal relationship with study treatment. SAEs were any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as an AE which occurred after the first dose of study treatment administration up to 30 days after the last dose of study treatment administration. The DLT observation period was 1 cycle (28 days). However, all AEs during treatment, unless due to disease progression or an obviously unrelated cause, were taken into consideration by the Study Committee for the determination of the maximum tolerated dose and recommended Phase 2 dose.

Phase 2: Percentage of Participants With Overall Response Rate (ORR)
From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

ORR by Investigator using international myeloma working group (IMWG) response criteria:percentage of participants with complete response (CR) (including stringent CR \[sCR\]very good partial response \[VGPR\] and partial response \[PR\]).CR:negative immunofixation on serum and urine,disappearance of any soft tissue plasmacytomas,less than (\<)5% plasma cells in bone marrow (BM) aspirates and normal free light chain(FLC)ratio (0.26-1.65).sCR:CR plus no clonal cells in BM biopsy.VGPR:serum and urine M-protein detectable by immunofixation,not electrophoresis;\>=90% reduction in serum M-protein plus urine M-protein level\<100mg/24hour(h);FLC only:\>=90% decrease in difference between involved and uninvolved FLC levels.PR:\>=50% reduction of serum M-protein and reduction in 24h urine M-protein by \>=90% or \<200mg/24h.In addition to above, if present at baseline,\>=50% reduction in size (sum of products of maximal perpendicular diameters of measured lesions \[SPD\]) of soft tissue plasmacytomas required.

Assessment of dose-limiting toxicities (DLTs) in VCDI cohort
Up to 6 weeks per treated patient
Overall response rate (VCDI)
Up to 34 weeks of treatment (induction phase)
Complete response rate (VCDI)
Up to 34 weeks of treatment (induction phase)
Complete response rate (VRDI)
Up to 104 weeks of treatment (induction and maintenance phase) in VRDI part A and part B cohorts
Dose Limiting Toxicities (DLTs)
Part A: Up to 4 weeks
Number of patients with adverse events and clinically significant changes in laboratory tests and vital signs according to the National Cancer Institute - Common Toxicity Criteria (NCI-CTC) version 4.03 grade scaling
Part A: Up to 30 days for patients experiencing progressive disease and up to one year or the initiation of a new line of treatment for patients leaving the study for reasons other than progressive disease
Incidence of grade ≥3 IARs according to the NCI-CTC version 4.03 grade scaling
Part B: Up to 8 weeks
Number of patients with adverse events when treated with SAR650984 (isatuximab) in combination with LD
Up to 30 days for patients experiencing progressive disease and continuously while patients are on treatment
Secondary Endpoints
Overall Response Rate (ORR)- Safety Run-in Part
Up to approximately 63 months
Duration of Response (DOR) - Safety Run-in Part
Up to approximately 63 months
Minimal residual disease (MRD) negativity -Safety Run-in Part
Up to approximately 36 months
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Isatuximab, lenalidomide, and dexamethasone (ILd)EXPERIMENTALParticipants will receive isatuximab \[intravenous (IV) administration\] in combination with lenalidomide \[per os (PO) administration\] and dexamethasone \[IV on Day 1 of Cycle 1 for participants receiving isatuximab IV only and PO otherwise for subsequent cycles\] for 24 cycles followed by isatuximab monotherapy for 12 cycles for a total duration of 36 cycles. 1 cycle = 28 days. Participants may receive other treatments as pre-medication.
Lenalidomide and dexamethasone (Ld)ACTIVE_COMPARATORLenalidomide \[PO administration\] in combination with dexamethasone \[PO administration\] for 24 cycles. 1 cycle = 28 days
Isatuximab/Bortezomib/Lenalidomide/Dexamethasone = IVRd armEXPERIMENTAL1. Induction treatment with 4x6-week cycles with intravenous (IV) isatuximab + subcutaneous (SC) bortezomib + oral lenalidomide + IV or oral dexamethasone 2. Continuous treatment with 4-week cycles with IV isatuximab + oral lenalidomide + IV or oral dexamethasone
Bortezomib/Lenalidomide/Dexamethasone = VRd armACTIVE_COMPARATOR1. Induction treatment with 4x6-week cycles with SC bortezomib + oral lenalidomide + IV or oral dexamethasone 2. Continuous treatment with 4-week cycles with oral lenalidomide + IV or oral dexamethasone
Isatuximab/Lenalidomide/Dexamethasone = IRd crossover armOTHER4-weeks cycles with IV isatuximab + oral lenalidomide + IV or oral dexamethasone
Isatuximab + Carfilzomib + Dexamethasone (IKd)EXPERIMENTALIsatuximab (intravenous) on day 1, 8, 15 and 22 of 1st cycle, then on day 1 and 15 of subsequent cycles in combination with carfilzomib (intravenous) on day 1, 2, 8, 9, 15 and 16 + dexamethasone (intravenous or by mouth \[po\]) on day 1, 2, 8, 9, 15, 16, 22 and 23 of a 28 day cycle.
Carfilzomib + Dexamethasone (Kd)ACTIVE_COMPARATORCarfilzomib (intravenous) on day 1, 2, 8, 9, 15, 16 + dexamethasone (intravenous or po) on day 1, 2, 8, 9, 15, 16, 22 and 23 of a 28 day cycle.
Isatuximab/cemiplimab (Regimen 1)EXPERIMENTALIsatuximab on Days 1, 8, 15, and 22, then Days 1 and 15 in 28-day cycles up to disease progression. Cemiplimab on Days 1 and 15 in 28-day cycle up to disease progression.
Isatuximab/cemiplimab (Regimen 2)EXPERIMENTALIsatuximab on Days 1, 8, 15, and 22, then Days 1 and 15 in 28-day cycles up to disease progression. Cemiplimab on Day 1 in 28-day cycle up to disease progression.
IsatuximabACTIVE_COMPARATORIsatuximab on Days 1, 8, 15 and 22, then Day 1 and 15 in 28-day cycles up to disease progression.
PomdeSAREXPERIMENTALPart A: Isatuximab (escalating dose) on Day 1, 8, 15, and 22, then Day 1 and 15 + pomalidomide 4 mg on Day 1 to 21 + dexamethasone 40 mg (20 mg in patients of 75 years or older) on Day 1, 8, 15, 22 in 28-day cycles up to disease progression Part B: Isatuximab 10 mg/kg on Day 1, 8, 15, and 22, then Day 1 and 15 + pomalidomide 4 mg on Day 1 to 21 + dexamethasone 40 mg (20 mg in patients of 75 years or older) on Day 1, 8, 15, 22 in 28-day cycles up to disease progression
SAR650984 (isatuximab)EXPERIMENTALSAR650984 (isatuximab) (escalating dose) plus lenalidomide 25 mg on Days 1 to 21 plus dexamethasone 40 mg on Days 1, 8, 15, 22 in 28-day cycles for all cohorts up to disease progression. For Q2W cohorts: SAR650984 (isatuximab) on Days 1 and 15 of every cycle. For QW/Q2W cohorts: SAR650984 (isatuximab) on Days 1, 8, 15, and 22 of first cycle and Days 1 and 15 of every subsequent cycle.
Interventions
NameTypeDescription
Isatuximab SAR650984DRUGPharmaceutical for: Solution for infusion Route of administration: Intravenous
LenalidomideDRUGPharmaceutical form: Capsules Route of administration: Oral
DexamethasoneDRUGPharmaceutical form: Tablets and solution for injection Route of administration: Oral and intravenous
Montelukast or equivalentDRUGAuxiliary Medicinal Product (AxMP)/pre-medication; ATC code: R03DC03; Pharmaceutical form: tablet; Route of administration: Oral;
AcetaminophenDRUGAxMP/pre-medication ATC code: N02BE01 Pharmaceutical form: tablet/ampule/capsule; Route of administration: Intravenous (IV) or per os (PO)
Diphenhydramine or equivalentDRUGAxMP/pre-medication ATC code: R06AA02 Pharmaceutical form: ampule; Route of administration: Intravenous
Methylprednisolone or equivalentDRUGAxMP/pre-medication; ATC code: H02AB04; Pharmaceutical form: vial; Route of administration: Intravenous
BortezomibDRUGPharmaceutical form: Lyophilized powder for injection Route of administration: Subcutaneous
carfilzomibDRUGPharmaceutical form: solution for infusion Route of administration: intravenous
Cemiplimab REGN2810DRUGPharmaceutical form: solution for infusion Route of administration: intravenous
cyclophosphamideDRUGPharmaceutical form: tablet Route of administration: oral
PomalidomideDRUGPharmaceutical form:capsules Route of administration: oral
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersYes
Study Sites105

Inclusion criteria: * Participants who are diagnosed within 5 years with SMM (per International Myeloma Working Group \[IMWG\] criteria), defined as serum M-protein ≥30 g/L or urinary M-protein ≥500 mg per 24 hour or both, and/or clonal bone marrow plasma cells (BMPCs) 10% to \<60%, and absence of ...

Countries:United StatesAustraliaBrazilCanadaChinaCzechiaDenmarkFranceGermanyGreeceHungaryIrelandIsraelItalyJapanLithuaniaNew ZealandNorwayPolandSouth KoreaSpainSwedenTurkey (Türkiye)United KingdomBelgiumMexicoPortugalRussiaTaiwan
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Recent Changes (Last 90 Days)
MEDIUMMay 26, 2026NCT03319667primaryCompletionDate: changed
LOWMay 26, 2026NCT04270409primaryCompletionDate: changed
LOWMay 24, 2026NCT03319667studyFirstPostDate: changed
LOWMay 24, 2026NCT04270409studyFirstPostDate: changed