Dr Banerjee on Various Dosing Schedules of Bispecific Antibodies in Myeloma

Rahul Banerjee, MD, FACP, assistant professor, Clinical Research Division, Fred Hutchinson Cancer Center; member, the International Myeloma Working Group; assistant professor, Division of Hematology and Oncology, University of Washington, discusses the ongoing investigation into different dosing schedules of bispecific antibodies in multiple myeloma.

The phase 1/2 MajesTEC-1 trial (NCT03145181; NCT04557098) provided primary data with teclistamab-cqyv (Tecvayli) in patients with relapsed/refractory multiple myeloma, Banerjee begins. This trial examined several dosing schedules, beginning with weekly dosing until disease progression. The results of this initial approach were published in The New England Journal of Medicine in 2022, he adds. Since then, additional cohorts within the trial have explored alternative dosing schedules, such as biweekly administration, to optimize treatment efficacy andpotentially reduce the burden on patients, Banerjee explains.

Elranatamab-bcmm (Elrexfio) has been primarily studied in patients with relapsed/refractory multiple myeloma in the phase 2 MagnetisMM-3 trial (NCT04649359), he continues. The dosing schedule for elranatamab evolved during the trial, shifting from weekly administration to every 2 weeks, and more recently, every 4 weeks, he reports. This ongoing adjustment of dosing cohorts has created challenges in interpreting key clinical outcomes, including progression-free survival, duration of response, and overall response rate, according to Banerjee. The variability in dosing schedules means the data differ between the specific time points analyzed, Banerjee emphasizes.

Linvoseltamab (REGN5458) has also been evaluated at different dosing schedules, with data published in June 2024 in the Journal of Clinical Oncology, he states. The phase 1/2 LINKER-MM1 trial (NCT03761108) investigated the agent at 2 dosage levels: 50 mg and 200 mg.

Investigations into reduced dosing schedules for bispecific antibodies in multiple myeloma are ongoing, and these trials continue to evolve, Banerjee continues. The broader trend in oncology research seeks to reduce the frequency of therapy and maintain the same level of clinical efficacy, he adds. This approach represents a promising direction in the management of multiple myeloma, offering the potential for enhanced quality of life for patients, Banerjee concludes.