Isa SC (on-body injector) + VRd Cuts Infusion Reactions and Neuropathy vs IV Isa-VRd, with Similar ≥VGPR in Ti NDMM (8-mo follow-up)

Isatuximab (anti-CD38 monoclonal antibody) + VRd was given either subcutaneously via an on-body injector (Isa OBI VRd; ISASOCUT Phase 2, n=74; weekly bortezomib after C1) or intravenously (Isa IV VRd; IMROZ Phase 3, n=265; twice-weekly bortezomib C1–4) in transplant-ineligible newly diagnosed multiple myeloma, analyzed at 8 months by age (<75 vs ≥75). Systemic infusion reactions were lower with SC vs IV (5% vs 22.8%), discontinuations due to TEAEs were numerically lower (2.7% vs 8.7%), and peripheral neuropathy favored the weekly bortezomib SC regimen: G2 PN (<75: 20.4% vs 28.7%; ≥75: 20% vs 35.3%) and G≥3 PN (<75: 2% vs 9.2%; ≥75: 0% vs 7.4%), while ≥VGPR rates were similar (<75: 87.8% vs 83.2%; ≥75: 80.0% vs 82.6%). Given that IMROZ previously showed a PFS benefit for adding Isa to VRd vs VRd (median PFS not reached vs 54.3 months; HR 0.596 at ~59.7-month follow-up), this cross-trial comparison mainly suggests tolerability/administration advantages (not improved efficacy) for SC delivery paired with a neuropathy-sparing bortezomib schedule.