Multiple Myeloma

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Welcome to Empower Multiple Myeloma

Multiple myeloma is a cancer of the plasma cells, which are a type of B cell responsible for active immunity. Antibodies from myeloma cells can damage the kidneys, bone, and other organs.

Multiple myeloma is diagnosed in more than 34,000 patients each year and causes more than 12,000 deaths annually.1-3 Highly effective combinations of treatment are available for the management of multiple myeloma, which have improved clinical outcomes for patients over time.

These include proteasome inhibitors, immunomodulatory drugs (IMiDs), and corticosteroids. As a result, more and more patients are living longer. At the same time, advanced therapies have been developed including antibody therapies such as4-7:

  • Signaling lymphocyte activation molecular family 7 (SLAMF7) antibodies
  • Anti-CD38 antibodies
  • B-cell maturation antigen (BCMA)-targeted antibody-drug conjugates
In addition to these therapies, multiple other therapies are in development, called bispecific antibodies. Of these agents, one agent–teclistamab–is currently approved. These antibodies can help bring together T cells, which are immune cells involved in targeting and destroying cancer cells, and specific receptors on cancer cells to help target multiple myeloma cells. Several bispecific antibodies are in active development in multiple myeloma targeting BCMA, including7:
  • Linvoseltamab (REGN5458)
  • Alnuctamab (CC-93269)
  • Elranatamab (PF-06863135)

This activity is provided by Med Learning Group.
This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.

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Note: This CME program was recorded prior to the American Society of Clinical Oncology (ASCO) 2023 meeting in June 2023. Highlights of data released at ASCO include:

Teclistamab

Longer-term data of the Phase 1/2 MajesTEC-1 study showed a high rate of deep and durable response in triple-class exposed MM patients. At 22 median follow up; complete response or better = 43%; duration of response = 24 months (27 months for ≥CR); median PFS = 12.5 months (20 months for ≥CR); median OS = 21.9 months (not reached for ≥CR).

Adverse event profile for all patients (and grade 3/4) included: infections = 78% (52%); CRS = 72% (0.6%); neutropenia = 72% (65%); anemia = 54% (38%); thrombocytopenia = 42% (22%); and lymphopenia = 35% (33%). ICANS occurred in 3% of patients, all grade 1 or 2.

Reference: van de Donk NWCJ, et al. Long-term follow-up from MajesTEC-1 of teclistamab, a B-cell maturation antigen (BCMA) x CD3 bispecific antibody, in patients with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol. 2023;41(suppl 16):8011. doi:10.1200/JCO.2023.41.16_suppl.8011

Linvoseltamab (investigational)

Two Phase 2 full dose cohorts (50 mg and 200 mg) in the LINKER-MM1 trial were studied to optimize dose selection. Linvoseltamab 200 mg showed better efficacy compared with 50 mg, including in patients with high disease burden. The 200 mg dose had consistent efficacy across high-risk subgroups and induced responses in pts who progressed on 50 mg. The recommended dose for further study is now 200mg.

ORR for 200 mg dose = 71%; CR = 30%; very good partial response = 59%. Median duration of response = not reached. The probability of maintaining response at 6 months was 84% and 79% at 12 months. Treatment-emergent adverse events were reported in 95% of patients (grade 3 or higher = 79%): CRS = 45% (1%); neutropenia = 33%; fatigue = 33%; anemia = 27% (24%). ICANS ≥grade 3 = 2%.

References:

Lee HC, et al. LINKER-MM1 study: Linvoseltamab (REGN5458) in patients with relapsed/refractory multiple myeloma. J Clin Oncol. 2023;41(suppl 16):8006. doi:10.1200/JCO.2023.41.16_suppl.8006

Updated Linvoseltamab (BCMAxCD3) Data from pivotal trial demonstrates early, deep, and durable responses in patients with heavily pre-treated multiple myeloma. News release. Regeneron Pharmaceuticals, Inc; May 25, 2025. Accessed June 15, 2023. https://investor.regeneron.com/news-releases/news-release-details/updated-linvoseltamab-bcmaxcd3-data-pivotal-trial-demonstrates

Elranatamab (investigational)

Pooled data from the MagnetismMM studies were presented. In pts with RRMM and prior exposure to BCMA-directed therapies, elranatamab was efficacious and well tolerated; no new safety signals were observed vs the BCMA-naïve population. ORR = 45.3% (prior anti-BCMA therapy = 41%-53%); median time to OR = 1.9 months; complete response or better = 17.4%; duration of response at 9 months = 72% (prior anti-BCMA therapy = 67.3%-78%); median PFS = 4.8 months; median OS 10-month endpoint not reached, but = 60.1% at 9 months.

Treatment-emergent adverse events in all patients (and grade 3 or higher) included: CRS = 65% (1%); anemia = 59% (47%); neutropenia = 44% (41%); thrombocytopenia = 41% (29%); diarrhea = 34% (0%); lymphopenia = 33% (30%); and ICANS = 6% (2%).

Reference: Nooka AK, et al. Efficacy and safety of elranatamab in patients with relapsed/refractory multiple myeloma (RRMM) and prior B-cell maturation antigen (BCMA)-directed therapies: A pooled analysis from MagnetisMM studies. J Clin Oncol. 2023;41(16 suppl):8008. doi:10.1200/JCO.2023.41.16_suppl.8008