Published October 2, 2023
Recently published in Nature Medicine, an article on the MagnetisMM-1 phase I trial provided an overview of elranatamab, a bispecific antibody that engages B cell maturation antigen (BCMA) on multiple myeloma (MM) and CD3 on T cells that has shown promising results. The trial evaluated the safety, pharmacokinetics, and efficacy of elranatamab for the treatment of relapsed or refractory MM. Eighty-eight patients received elranatamab monotherapy, and 55 patients received doses that demonstrated efficacy. Andrew Dalovisio, MD, hematology oncologist at Ochsner MD Anderson Cancer Center, is a contributing author.
The trial included patients who had received a median of five prior regimens, with 90.9% considered triple-class refractory. Additionally, 29.1% of patients had high cytogenetic risk, and 23.6% had received prior BCMA-directed therapy. However, no dose-limiting toxicities were observed during dose escalation, and adverse events were manageable.
Elranatamab achieved an objective response rate (ORR) of 63.6%, with 38.2% of patients achieving a complete response or better. The median duration of response (DOR) for responders was 17.1 months, and all 13 patients evaluable for minimal residual disease achieved negativity. Notably, even patients who had received prior BCMA-directed therapy achieved a response rate of 53.8%.
The trial also demonstrated favorable progression-free survival (PFS) and overall survival (OS) outcomes. The median PFS for all 55 patients was 11.8 months, and the median OS was 21.2 months. These results indicate that elranatamab can provide durable responses and promising survival outcomes for patients with relapsed or refractory MM.
“We are in new golden age of therapy for multiple myeloma. We have many new immunotherapies, including Bispecific T cell engagers (BiTE’s), which harness our own immune system’s innate ability to kill malignant cells,” said Dr. Dalovisio. “Historically, patients with multiple myeloma who had progressed through all the previously approved therapies had limited options and very poor outcomes. The MagnetisMM-1 trial conducted at multiple cancer centers, including The Gayle and Tom Benson Cancer Center at Ochsner MD Anderson Cancer Center, studied the BCMA directed Bispecific T-cell engager elranatamab in heavily pretreated multiple myeloma patients. We found that it demonstrated response rates and durations of response almost two to three times more than historical therapies in this group.”
Overall, the MagnetisMM-1 trial has shown that elranatamab is a safe and effective treatment option for MM, particularly in patients with limited other treatment options. With its ability to engage BCMA and T cells, elranatamab offers a promising new approach for the treatment of this challenging malignancy.
Dr. Dalovisio continued, “The data from this study contributed to the FDA approving elranatamab in August 2023. It’s a wonderful feeling to be able to offer patients a new treatment that could potentially extend their lives by years.”
