Sarclisa
Sarclisa (isatuximab or isatuximab-irfc) is a monoclonal antibody that’s used to treat a type of blood cancer called multiple myeloma. It helps stop the cancer from growing and spreading. Sarclisa (isatuximab) is given as an intravenous infusion through your vein (IV). It’s typically given together with two other medications to treat cancer. Sarclisa (isatuximab) might cause side effects such as infusion-related reactions, low white blood cell counts, and diarrhea.
What is Sarclisa (isatuximab)?
What is Sarclisa (isatuximab) used for?
Multiple myeloma in adults who’ve received at least two previous therapies, given together with Pomalyst (pomalidomide) and dexamethasone
Multiple myeloma in adults who’ve received one to three previous therapies, given together with Kyprolis (carfilzomib) and dexamethasone
How Sarclisa (isatuximab) works
Sarclisa (isatuximab) is an anti-CD38 monoclonal antibody. It specifically attaches to proteins called CD38 that are found on the surface of cells. Sarclisa (isatuximab) is able to attach only to cancer cells (like those of multiple myeloma) because they have more of this protein than healthy cells.
Once Sarclisa (isatuximab) attaches to CD38 on the cancer cells, it sends signals to the immune system to come attack it. Sometimes, the medication can attack the cell itself. This helps stop the cancer from growing and spreading.
Drug Facts
What are the side effects of Sarclisa (isatuximab)?
Common Side Effects
- Lower red blood cell counts (up to 99%)
- Lower white blood cell counts (up to 96%)
- Lower platelet counts (up to 94%)
- Upper respiratory infection (e.g., sinus infections, bronchitis; up to 67%)
- Infusion-related reaction (up to 46%)
- Tiredness (42%)
- Higher blood pressure (37%)
- Pneumonia (up to 36%)
- Diarrhea (up to 36%)
- Trouble breathing (up to 29%)
- Cough (23%)
Other Side Effects
- Nausea
- Vomiting
- Low white blood cell counts along with fever (febrile neutropenia)
Serious Side Effects
- Serious reaction during infusion: itching, cough, trouble breathing, fast heart beat, face swelling, feeling warm or hot
- Low white blood cells: fever, signs of infection (e.g., cough, body aches, chills)
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Infection—fever, chills, cough, or sore throat
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Sarclisa (isatuximab)
Pros
Recommended treatment option for previously-treated multiple myeloma
Works in a more specific, targeted way than traditional chemotherapy
Doesn’t commonly cause typical chemotherapy side effects, such as nausea, vomiting, or hair loss
Cons
Given as an infusion through the veins, so requires a needle for administration
Might cause serious infusion-related reactions
Might make it more difficult for your body to fight infection
Pharmacist tips for Sarclisa (isatuximab)
Because Sarclisa (isatuximab) might cause infusion reactions, you’ll take several medications before each dose to prevent a serious reaction. These medications might include acetaminophen (Tylenol) and an antihistamine, like diphenhydramine (Benadryl).
If you have diarrhea while you’re taking Sarclisa (isatuximab), remember to drink plenty of fluids. Make sure to avoid sugary drinks because they can make diarrhea worse. Your provider might suggest you take over-the-counter diarrhea medications, like loperamide (Imodium A-D), to help.
Try not to get sick by washing your hands often, avoiding crowds, and washing raw fruits and vegetables thoroughly before eating them. This is important because Sarclisa (isatuximab) can make your white blood cell counts drop, which can make it harder for your body to fight infections if you get sick.
Check your temperature regularly (for example, once a day). Call your provider right away if your temperature is 100.4 degrees Fahrenheit or higher; this means you have a fever. It’s important for your provider to know if you get sick, and sometimes a fever can be the only sign that you’re sick.
Sarclisa (isatuximab) is typically given along with other medications to treat multiple myeloma, and it can be difficult to keep track of the treatment schedule. Talk to your provider about using a treatment calendar so all your doses and infusion appointments are written down. You can also consider using an app on your phone to help you remember.
Frequently asked questions about Sarclisa (isatuximab)
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What are the risks and warnings for Sarclisa (isatuximab)?
Sarclisa (isatuximab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infusion-related reactions
Many people have experienced an infusion-related reaction during treatment with Sarclisa (isatuximab). Most of the time, these reactions happened during the first treatment. Because of this, your first treatment will be given more slowly. To help prevent a reaction, your nurse will give you medications such as diphenhydramine (Benadryl) and acetaminophen (Tylenol). They’ll also closely watch for reactions during your infusion.
Symptoms of an infusion reaction related to Sarclisa (isatuximab) usually includes trouble breathing, cough, stuffy nose, and nausea. More seriously, infusion reactions can also cause swelling in the face and changes in blood pressure. If you have any symptoms of a reaction during your infusion, tell your nurse right away. Some people who have a reaction can still take Sarclisa (isatuximab). But sometimes, the reaction is severe and the medication must be permanently stopped.
Low white blood cell counts
People who take Sarclisa (isatuximab) commonly have low blood cell counts, particularly low white blood cells (also called neutropenia). White blood cells are an important part of your immune system. When they’re low, you might be at higher risk for serious and life-threatening infections.
Your provider will check your blood cell counts before every Sarclisa (isatuximab) treatment. They might prescribe other medications such as antibiotics or antivirals to protect you from serious infections.
It’s important to lower your risk of getting sick by washing your hands often and avoiding crowds. Check your temperature regularly, and call your provider right away if your temperature is 100.4 degrees Fahrenheit or higher.
New cancers
Some people taking Sarclisa (isatuximab) developed a new cancer. In studies, skin cancers were the most commonly reported new cancer. But there were also a few cases of angiosarcoma (a rare cancer of the blood and lymph vessels) and a blood cancer called myelodysplastic syndrome. Your provider will monitor you for new signs and symptoms of cancer, especially skin cancers, while you’re taking Sarclisa (isatuximab).
Changes to other lab test results
Risk factors: Blood transfusion
Sometimes, people with multiple myeloma need certain tests to monitor their red blood cells (such as a Coombs test) or other tests to check for blood compatibility before they receive a blood transfusion. In addition to those found on cancer cells, Sarclisa (isatuximab) can attach to CD38 proteins found in low numbers on red blood cells. This can affect your test results; the lab result reading might say they’re abnormal when they’re in fact normal.
To account for this, the lab or blood bank takes extra steps to make sure they get the correct test results for you. Be sure everyone who’s taking care of you and performing any type of lab test knows that you’re taking Sarclisa (isatuximab). This helps them know that they need to take those extra steps to make sure your lab results are correct.
Harm to unborn baby
Based on animal studies, Sarclisa (isatuximab) might harm an unborn baby when it’s taken during pregnancy. Because of this risk, if you’re a woman who can have children, you should use birth control while taking Sarclisa (isatuximab) and for 5 months after the last dose. Let your provider know right away if you become pregnant while taking Sarclisa (isatuximab).
Sarclisa (isatuximab) dosage forms
Typical dosing for Sarclisa (isatuximab)
This medication is given as an intravenous (IV) infusion. The dose is based on your body weight.
The typical dose is 10 mg/kg of body weight given once a week for the first cycle (4 weeks). For the following cycles, the medication is given once every 2 weeks.
What are alternatives to Sarclisa (isatuximab)?
Multiple myeloma in adults who’ve received at least two previous therapies, given together with Pomalyst (pomalidomide) and dexamethasone
Multiple myeloma in adults who’ve received one to three previous therapies, given together with Kyprolis (carfilzomib) and dexamethasone
Adults newly diagnosed with multiple myeloma (MM), but not able to receive stem cell transplant (in combination with other anticancer medications)
Adults newly diagnosed with MM and able to receive stem cell transplant (in combination with other anticancer medications)
Adults with advanced MM who already received but didn’t respond well to at least one prior anticancer treatment (in combination with other anticancer medications)
Adults with advanced MM who already received but didn’t respond well to at least three prior anticancer treatments (given alone)
Multiple myeloma in people who’ve already taken 1 to 3 therapies; given with lenalidomide (Revlimid) and dexamethasone
Multiple myeloma in people who’ve already taken at least 2 therapies; given with Pomalyst (pomalidomide) and dexamethasone
Sarclisa (isatuximab) images
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References
Best studies we foundAmerican Cancer Society. (n.d.). Fevers.
American Cancer Society. (n.d.). Targeted therapy.
American Cancer Society. (2018). What is multiple myeloma?
American Cancer Society. (2020). What are infusion or immune reactions?
American Cancer Society. (2023). Low white blood cell counts (neutropenia).
Centers for Disease Control and Prevention. (2023). Shingles (herpes zoster): Clinical overview.
Centers for Disease Control and Prevention. (n.d.). What you need to know: Neutropenia and risk for infection.
Gozzetti, A., et al. (2022). Anti CD38 monoclonal antibodies for multiple myeloma treatment. Human Vaccines & Immunotherapeutics.
Leukemia and Lymphoma Society. (n.d.). Blood transfusion.
National Cancer Institute. (2019). Angiosarcoma.
National Cancer Institute. (2023). Myelodysplastic syndromes treatment (PDQ®)–Patient version.
National Comprehensive Cancer Network. (2021). Anemia and neutropenia: Low red and white blood cell counts.
National Comprehensive Cancer Network. (2023). Multiple myeloma.
Patel, K., et al. (2017). Febrile neutropenia. Journal of the American Medical Association Oncology.
sanofi-aventis U.S. LLC. (2022). Possible side effects of Sarclisa.
sanofi-aventis U.S. LLC. (2023). Sarclisa- isatuximab injection, solution, concentration [package insert]. DailyMed.
Skin Cancer Foundation. (2023). Squamous cell carcinoma overview.
Song, J., et al. (2021). Review: Effects of anti-CD38 monoclonal antibodies on red blood cell transfusion and interventions. Journal of Clinical Laboratory Analysis.
Theis, S. R., et al. (2022). Coombs test. StatPearls.
van de Donk. N. W. C. J., et al. (2018). CD38 antibodies in multiple myeloma: Mechanisms of action and modes of resistance. Frontiers in Immunology.
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