Current Concepts in the Management of Relapsed/Refractory Multiple Myeloma: Considerations With Bispecific Anti-BCMA Antibodies

Jonathan L. Kaufman, MD (Program Chair)
Medical Director and Section Chief
Winship Cancer Institute Ambulatory Infusion Centers
Emory Winship Cancer Center
Atlanta, GA
Sarah Holstein, MD, PhD
Professor, Division of Oncology & Hematology
Multiple Myeloma
University of Nebraska Medical Center
Omaha, NE

PROGRAM OVERVIEW

This educational enduring activity is designed to help clinicians in treating and managing patients with relapsed/refractory multiple myeloma.

TARGET AUDIENCE

This enduring activity is designed to meet the educational needs of community-based oncologists, hematologists, hematology pharmacists, nurse practitioners, and physician’s 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:

  • Assess resistance as a factor in treatment decisions in relapsed/refractory multiple myeloma in consideration of therapies that target BCMA
  • Evaluate current mechanisms of resistance in the relapsed/refractory setting in multiple myeloma and the limitations of available therapies
  • Summarize current data in the use of bispecific anti-BCMA antibodies in management of relapsed/refractory multiple myeloma in consideration of emerging efficacy and safety data

Accreditation Statement

Med Learning Group is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with the ACCME Essentials.

Physician Credit Designation Statement

Med Learning Group designates this live 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 live activity.

JOINT ACCREDITATION STATEMENT

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and Med Learning Group. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

NURSES (ANCC) CREDIT DESIGNATION

Amedco LLC designates this activity for a maximum of 1.0 ANCC contact hours.

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

Speaker Relationship Manufacturer
Jonathan L. Kaufman, MD Consultant BMS, AbbVie, Incyte
 

Sarah Holstein, MD, PhD

 

Consultant Janssen, Takeda, Oncopeptides, AbbVie, Secura Bio, Bristol Myers Squibb
Contract Research Institutional funding: Janssen, Bristol Myers Squibb, Oncopeptides, Takeda

All relevant financial relationships have been mitigated.

CME Content Review

The content of this enduring activity was independently peer reviewed.

The reviewer of this enduring activity has nothing to disclose.

CNE Content Review

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

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 or their spouse/life partner 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.
Sharine Griggs, Senior Program Manager for Med Learning Group, has nothing to disclose.
Chris Drury, Medical Services for Med Learning Group, has nothing to disclose.
Lauren Welch, MA, VP, Accreditation and Outcomes, has nothing to disclose.
Aimee Meissner, Accreditation and Outcomes Manager, has nothing to disclose.
Emmanuella Foucault, Program Coordinator, 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.

METHOD OF PARTICIPATION

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

  1. Read the CME/CNE information and faculty disclosures.
  2. Participate in the enduring activity.
  3. Submit the evaluation form to Med Learning Group.

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 expertise 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 DISABILITY ACT

Event staff will be glad to assist you with any special needs (eg, physical, dietary, etc.).  Please contact Med Learning Group prior to the live event at info@medlearninggroup.com

Copyright © 2023 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.

Scroll to Top
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