Iberdomide

What is ibertamide? Ibertamide is a cell mod or a cerebral modulator. And so if we think about this class of drugs called imides, first came dilatomide, lenalidomide, pomalidomide, or thalamine, revlimid, and pomelis. And now we know that patients become resistant to all of those drug classes. And so now there's been an engineering effort to create molecules that overcome resistance to those, and those are called these cell mods. Ibertamide is one of them, so it's an oral medication that has been shown to kill myeloma. How is ibertamide administered? Ibertamide is administered orally, so it's similar to the other imid drugs from which the original ancestry of the drug, if you will. So it's daily for three weeks on, one week off, and combined usually with dexamethasone, so weekly dex. What is the typical dosage? After the completion of dose escalation, it looks like the recommended phase two dose, and what's going forward is 1.6 milligrams. However, lower doses are being studied in the maintenance setting, so it depends on which disease state the drug is being tested. What are the most common side effects? The side effects of ibertamide are the typical kind of side effects of this drug class, so some lowering of blood counts, particularly the neutrophils, some infections. But these are generally modest and lacks a lot of the other side effects that sometimes the ancestral drugs might have had, like we don't see as much diarrhea or fatigue or neuropathy. So we're looking forward to having access to this drug. Is ibertamide a monotherapy or is it used in combination with other drugs? Right now, ibertamide is not yet approved, and the initial submission for ibertamide with dexamethasone has not been approved. So the pivotal study that will lead to its registration and approval is a randomized phase three. The study is known as Excalibur, so it's daratumumab ibertamide index versus daratumumab bortezumab index, and so we'll see if those results hopefully are favorable, we can have access to the drug.