Considerations With Bispecific Antibodies in Development— Understanding Current Data in the Later-Line Relapsed/Refractory Multiple Myeloma Treatment Setting The EMPOWER Initiative

PROGRAM CHAIR

Craig C. Hofmeister MD, MPH
Professor, Department of Hematology and Medical Oncology
Emory University School of Medicine
Atlanta, GA

PROGRAM OVERVIEW

This enduring activity addresses the mechanisms of resistance and characteristics of refractory disease in patients with multiple myeloma; reviews the mechanisms of action of both current and emerging therapies in the treatment of patients with relapsing/refractory multiple myeloma; and lastly evaluates the clinical data for developing agents in the management of patients with late relapse/refractory multiple myeloma.

TARGET AUDIENCE

This activity is designed to meet the educational needs of oncologists, hematologists, hematology pharmacists, nurse practitioners, and physician assistants to ensure confidence in the management of relapsed/refractory multiple myeloma.

LEARNING OBJECTIVES

Upon the completion of this program, attendees should be able to:

  • Evaluate current outcomes in the relapsed/refractory setting of multiple myeloma and the need for novel therapies for management of patients who have received multiple prior lines of therapy
  • Visualize the mechanism of bispecific antibodies in the management of relapse/refractory multiple myeloma, with a focus on novel bispecific agents in clinical development
  • Summarize up-to-date clinical trial data concerning the bispecific antibodies in development for the later-line management of relapsed/refractory multiple myeloma

ACCREDITATION STATEMENT

Med Learning Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with the ACCME Essentials.

CREDIT DESIGNATION STATEMENT

Med Learning Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the enduring activity.

NURSING CREDIT INFORMATION

Purpose: This program would be beneficial for nurses involved in the care of patients with multiple myeloma.
CNE Credits: 1.0 ANCC Contact Hour.

CNE ACCREDITATION STATEMENT

Ultimate Medical Academy/CCM is accredited as a provider of nursing continuing professional education development by the American Nurses Credentialing Center’s Commission on Accreditation.

Awarded 1.0 contact hours of continuing nursing education of RNs and APNs.

DISCLOSURE POLICY STATEMENT

In accordance with the Accreditation Council for Continuing Medical Education ACCME Standards for Integrity and Independence in Accredited Continuing Education, educational programs sponsored by Med Learning Group must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors, editors, staff, and planning committee members participating in an MLG-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity.

DISCLOSURE OF CONFLICTS OF INTEREST

Craig C. Hofmeister MD Discloses that he has worked on advisory boards for Janssen, GSK, BMS, and Sanofi.

CME Content Review

The content of this activity was independently peer reviewed.
The reviewer of this activity has nothing to disclose.

CNE Content Review

The content of this activity was peer reviewed by a nurse reviewer.

Douglas Cox, MSN, MHA, RN
Ultimate Medical Academy/CCM – Lead Nurse Planner

The reviewer of this activity has nothing to disclose.

Staff Planners and Managers

The staff, planners, and managers reported the following financial relationships or relationships to products or devices they have with ineligible companies related to the content of this CME/CE activity:

  • Matthew Frese, MBA, General Manager of Med Learning Group, has nothing to disclose.
  • Christina Gallo, SVP, Educational Development for Med Learning Group, has nothing to disclose.
  • Michael Page, PharmD, RPh, Medical Director for Med Learning Group, has nothing to disclose.
  • Lauren Welch, MA, VP, Accreditation and Outcomes for Med Learning Group, has nothing to disclose.
  • Douglas Cox, MSN, MHA, RN, UMA/CCM – LNP, has nothing to disclose.
  • Melissa A. Johnson, Senior Program Manager for Med Learning Group has nothing to disclose.
  • Amanda Jenkins, Program Manager for Med Learning Group has nothing to disclose.
  • Natalie Smith, Program Coordinator for Med Learning Group has nothing to disclose.
  • Daniel Dasilva, Accreditation and Outcomes Coordinator for Med Learning Group, has nothing to disclose.

DISCLOSURE OF UNLABELED USE

Med Learning Group requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States. During this lecture, the faculty may mention the use of medications for both FDA-approved and non-approved indications.

METHOD OF PARTICIPATION

There are no fees for participating and receiving CME credit for this enduring activity. To receive CME/CNE credit participants must:

  1. Read the CME/CNE information and faculty disclosures
  2. Participate in the enduring activity
  3. Complete pre-and-post surveys and evaluation

You will receive your certificate as a downloadable file.

DISCLAIMER

Med Learning Group makes every effort to develop CME activities that are science based.
This activity is designed for educational purposes. Participants have a responsibility to use this information to enhance their professional development in an effort to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision making before applying any information, whether provided here or by others, for any professional use.

For CME questions, please contact Med Learning Group at info@medlearninggroup.com
Contact this CME provider at Med Learning Group for privacy and confidentiality policy statement information at www.medlearninggroup.com/privacy-policy/

AMERICANS WITH DISABILITIES ACT

Staff will be glad to assist you with any special needs. Please contact Med Learning Group prior to participating at info@medlearninggroup.com

RELEASED DATE: January 05 , 2023
EXPIRATION DATE: January 05 , 2024

 

Copyright © 2022 Med Learning Group. All rights reserved. These materials may be used for personal use only. Any rebroadcast, distribution, or reuse of this presentation or any part of it in any form for other than personal use without the express written permission of Med Learning Group is prohibited.

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