Linvoseltamab for Relapsed/Refractory Multiple Myeloma: Results from IMS 2023 With Madhav Dhodapkar, MD
At the International Myeloma Society (IMS) 2023 Annual Meeting and Exposition, Dr. Madhav Dhodapkar, Director of the Cancer Center at Emory University, presented the results of the LINKER-MM1 trial of linvoseltamab for relapsed/refractory multiple myeloma. Here, he further delves into the efficacy of linvoseltamab observed in the trial and its projected place in the treatment landscape.
Oncology Data Advisor: Welcome to Oncology Data Advisor. Today, I have the honor of being joined by Dr. Dhodapkar, who is here to discuss the results of a trial presented at the IMS Meeting. Dr. Dhodapkar, thank you so much for coming on today.
Madhav Dhodapkar, MD: It's really a pleasure. Again, my name is Madhav Dhodapkar. I'm a Professor of Hematology and Medical Oncology at Emory University. I'm here at the International Myeloma Society meeting in Greece to discuss the results of a clinical trial of linvoseltamab in multiple myeloma.
Oncology Data Advisor: Awesome. For a little bit of background, would you like to tell us about linvoseltamab and its mechanism of action?
Dr. Dhodapkar: Linvoseltamab is a bispecific antibody. What that means is that one end of the antibody binds to tumor cells or myeloma cells through targeting the molecule called B-cell maturation antigen (BCMA). The other end targets T cells by targeting a molecule called CD3, so it's a CD3 BCMA bispecific antibody. What that does is it brings the tumor cells and the immune cells, which are T cells, close to each other so that the T cells can then kill the tumor cells directly.
Oncology Data Advisor: Great. What is the LINKER-MM1 study investigating?
Dr. Dhodapkar: This trial is basically testing the effects of this bispecific antibody in patients with relapsed/refractory multiple myeloma that has relapsed following multiple lines of therapy. This is a patient population with unmet needs because although we've made a lot of progress in treating multiple myeloma, with several new kinds of therapies, we know that patients still progress after receiving those therapies. There's a need for newer agents to treat those patients. This trial is targeting that patient population with this new class of agents.
Oncology Data Advisor: What are the efficacy results of the trial that you're presenting this week?
Dr. Dhodapkar: We're actually quite excited about the results of this study. This study was based on prior studies, and we established a dose of 200 mg to treat patients with relapsed/refractory multiple myeloma. This specific presentation describes the results of treating a cohort of patients with that dose of linvoseltamab. What we are excited to find is that over 70% of patients achieved a response following therapy in this setting, with 71% achieving a very good partial response. This means significant reduction in the protein levels. Nearly 30% of patients achieved a complete response or better, which means that we can't detect the myeloma protein anymore in blood or urine or bone marrow. Therefore, these results are quite promising because this is a very high response rate for a previously treated patient population like this.
Oncology Data Advisor: That's really exciting to hear. So, were there any notable toxicities or anything unexpected?
Dr. Dhodapkar: With bispecific antibodies, one of the side effects that we typically think about is cytokine release syndrome. While cytokine release syndrome is expected to some degree to be observed with this class of agents, what was unique about this trial was that the incidence of grade three cytokine release syndrome was actually very low, with just a few patients experiencing it. The incidence of immune cell effector–associated neurologic syndrome (ICANS) was also very low. Both of these two major toxicities that we typically see with bispecifics were lower. The main toxicities were still pretty much as expected. We expect some hematologic toxicity with this class of agents, and that was observed but was very manageable. Then the other adverse events that I think we are observing across all bispecifics right now in this class of drugs is the risk of infections.
Oncology Data Advisor: Good to know. What do these results of linvoseltamab mean for the treatment of multiple myeloma?
Dr. Dhodapkar: These data really make us very hopeful. They suggest that linvoseltamab is likely to be another BCMA bispecific that could soon be, we hope, approved and available for the treatment of multiple myeloma patients. there are already two other bispecifics against this target already FDA approved. We expect that this drug will soon be available for treating patients because it has clearly shown to be a promising drug.
Oncology Data Advisor: What are the next steps for LINKER-MM1?
Dr. Dhodapkar: Typically, the next step with these things is to do a phase three trial comparing it with other therapies, and this is currently ongoing. We hopefully should have this drug available to patients in the very near future, even before the data from the phase three trial is actually available.
Oncology Data Advisor: That's very exciting. Thank you so much for coming on today and telling us all about the trial. It's really awesome to hear about.
Dr. Dhodapkar: Thank you for having me.
About Dr. Dhodapkar
Madhav Dhodapkar, MD, is a Professor of Hematology and Medical Oncology and the Director of the Center for Cancer Immunotherapy at Winship Cancer Institute of Emory University in Atlanta, Georgia. He is also the Georgia Research Alliance Eminent Scholar in Cancer Innovation at Emory University School of Medicine. Dr. Dhodapkar specializes in the treatment of multiple myeloma, and his research focuses on the immunobiology of multiple myeloma and the development of novel biological approaches for therapy. He is credited with helping to define the role of the immune system in controlling early cancer cells.
For More Information
Dhodapkar M (2023). Efficacy and safety of linvoseltamab 200 mg in patients with relapsed/refractory multiple myeloma (RRMM): analysis of the LINKER-MM1 study. Presented at: 2023 International Myeloma Society Annual Meeting and Exposition. Abstract P-247.
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.