Dr Suzanne Lentzsch Highlights Promising Linvoseltamab Results in Treating RRMM

At the European Hematology Association (EHA) 2024 Congress, Suzanne Lentzsch, MD, PhD, director of the multiple myeloma and amyloidosis program and professor of medicine at Columbia University's College of Physicians and Surgeons, discussed the efficacy of the bispecific antibody linvolseltamab in treating patients with relapsed/refractory multiple myeloma (RRMM) as explored in the phase 1/2 LINKER-MM1 study (NCT03761108).

Dr Suzanne Lentzsch | Image Credit: Columbia University - cancer.columbia.edu

The American Journal of Managed Care^® (AJMC^®): Could you briefly summarize the LINKER-MM1 study and its conclusions about linvoseltamab?

Lentzsch: Today [June 16, 2024], I presented the data on linvoseltamab. It was a phase 1/2 clinical trial in which 117 patients received linvoseltamab at a dose level of 200 mg; the patients were heavily pretreated with a median 5 prior lines of treatment. Also, there was a significant number of frail patients. We had 26.5% of patients over 75 years old, 16% of patients had extramedullary plasmacytomas, and 39% of patients had high-risk cyogenetics.

The schedule of this bispecific is very convenient. During weeks 1 and 2, patients receive step-up dosing, with 5 mg on day 1 and 25 mg on day 8. From week 3 to week 14, patients receive a weekly treatment of 200 mg. Then, after, 200 mg is given biweekly. After 24 weeks, and achieving a VGPR [very good partial response], patients will have a monthly treatment. So, it's a very convenient schedule.

I think also what was striking was the response rate as 50% of the patients achieved complete remission or better; I think that's really remarkable. Patients receiving a median 5 prior lines of treatment, 71% of the patients saw an overall response rate.

For the supplemental analysis, we also saw that especially older patients, they had 55% complete response rate and high-risk cytogenetics, as well as patients with extramedullary multiple myeloma had an excellent response.

AJMC: How do the efficacy and safety findings of linvoseltamab compare to other available treatments for RRMM?

Lentzsch: Currently, it's very difficult to do cross-trial comparisons. We usually try to avoid this because each trial has a different inclusion criteria. So, it's not really fair to compare all those trials.

Interestingly, what we see with linvoseltamab is a relatively good safety profile. CRS [cytokine release syndrome] occurred in 46% of the patients, but they were mostly grade 1 and grade 2 so they could be very well managed. Only 1% had a grade 3 CRS, so, from that standpoint, it was very well tolerated.

We also saw infections in 74% of the patients, 36% of the patients had grade 3/4 infections, but with IVIG [intravenous immunoglobin], and also with giving antibiotics for PCP [pneumocystis pneumonia] prophylaxis, we had very good results in managing infections.

AJMC: What further research is needed to establish the value of linvoseltamab in treating patients with RRMM?

Lentzsch: First of all, we have to finish the clinical trials, which are currently ongoing with linvolseltamab. I'm pretty sure that we right now have already the correct dosage of 200 mg. We also have a good safety profile, we know that to give bispecifics to also concomitantly give IVIG and antibiotics.

So, I think we are quite ready to have the next bispecific antibody approved. The big question is really, how do we select the right bispecific antibody for our patient population? That is an answer I cannot really answer right now. I hope that having 3 approved bispecific antibodies, we will have some competition in the market, and maybe the price will decide which antibody we are using for our patients.