Table 2 Updated results from major clinical trials with BsAbs in combinations in RR MM.
From: Bispecific antibodies in the treatment of multiple myeloma
MajesTEC-2 [79] | MajesTEC-2 sub-cohort [118] | MonumenTAL-2 [85] | TRIMM-2 [84] | RedirecTT-1 [41] | |
---|---|---|---|---|---|
Agent | Teclistamab + Daratumumab + Lenalidomide | Teclistamab + Nirogacestat | Talquetamab + Pomalidomide | Talquetamab + Daratumumab | Teclistamab + Talquetamab |
No. of patients (n) | 32 | 27 | 35 | 65 | 63 |
Patient characteristics | Median 2 (1–3) LOT, 31.3% antiCD38 Mo-B exposed | Median 4 (2–12) prior LOT 71.4% triple class refractory 21.4% penta-refractory | Median 3 prior LOT, 6.3% penta-refractory 18.3% prior CAR T 6.3% prior BsAb | Median 5 (2–16) prior LOT, 58% triple class refractory, 63% penta-refractory, 18% high risk cytogenetics, 25% with EM plasmacytomas | Median 5 (1–11) prior LOT, 78% triple class refractory, 63% penta drug exposed, 33% high-risk cytogenetics, 43% EMD |
mFU in months (range) | 5.78 (1–10.4) | 14.7 | 11.4 | 11.5 (1.0–27.3) | 14.4 (0.5–21.9) |
Response | ORR: 13/13 and VGPR: 12/13 at 0.72 mg/kg | ORR—74.1 ≥CR—51.9 87% maintained response at 12 months | ORR >80% Response as early as 1 (0.9–2.1) month | 75% ORR (66% ≥VGPR, 45% ≥CR) | All patients: 84% ORR, 34 % CR EMD: 73% ORR, 31% CR |
mDOR (months) | NA | Not reached | Not reached | NA | Not reached |
mPFS (months) | NA | NA | Not reached | 19.4 | NA |
mOS (months) | NA | NA | NA | 93% at 12 months | NA |
CRS | 81.3 (All Gr 1, 2) | 0 | 74.3%, 2.9% Gr 3 | 54.5% (all Gr 1) | 81%, 3% Gr 3, no Gr 4 |
ICANS | Nil | 1 (Gr 3) | 2 (both Gr 1) | 5% | 1 event at dose level 3 |
Other adverse events | Neutropenia (Gr 3/4)—68.8% | 5 Gr 5 TAE—sepsis, septic shock, COVID-19, cardiac arrest, PJP pneumonia | Grade 3/4 neutropenia 48.6%, anemia 25.7, thrombocytopenia—20%, COVID-19—14.3% | Neutropenia (38%), Grade 3/4 26% | Neutropenia—76%, Gr 3/4 (75%) Anemia—60%, Gr 3/4 43% |