MM-466 Early Impressions With Use of BCMA-Directed Therapy: Elranatamab in Multiply Relapsed/Refractory Multiple Myeloma: A Safety and Efficacy Analysis in a Tertiary Cancer Center in India

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2024-09, Vol.24, p.S559-S559
• Main Authors: Podder, Dibakar, Patil, Noopur, Brahma, Anupam, Shewale, Sundar, Javed, Rizwan, Chattopadhyay, Debranjani, Ghosh, Shouriyo, Nag, Arijit, Kumar, Jeevan, Rath, Ashish, Vinarkar, Sushant, Parihar, Mayur, Mishra, Deepak, Chakraborty, Subhosmito, Nair, Reena
• Format: Article
• Language: English
• Subjects: BiTE; elranatamab; infections; relapsed/refractory multiple myeloma
• ISSN: 2152-2650
• DOI: 10.1016/S2152-2650(24)01685-9

Multiple myeloma (MM) is a plasma cell dyscrasia characterized by expression of B-cell maturation antigen (BCMA). Elranatamab (PF-06863135), a bispecific antibody that targets BCMA and CD3 on T cells, activates and redirects the T-cell-mediated cytotoxic immune response against myeloma cells. The primary aim of this study was to assess the safety and toxicity profile, predominantly highlighting the infections with the use of elranatamab in relapsed/refractory MM. The secondary objective was to determine efficacy and time to response. Retrospective observational study between April 2023 and May 2024, with a sample size of 6. All patients received s/c elranatamab 76 mg QW on a 28-d cycle with a 2-step-up priming dose regimen of 12 mg on day 1 and 32 mg on day 4 during the first week. Drugs were procured via named patient compassionate drug access program. Median age was 60 years (range, 30-67 years); 66.7% were male and 33.3% were female. 33.33% of pts had high-risk cytogenetics, 50% had R-ISS III. Pts had received a median of 5 (range, 3-8) prior lines of therapy. The median duration of elranatamab treatment was 41.5 days (range, 5-49 days). The most common hematologic AE: anemia, n=5 (83.33%). The most common nonhematologic AE: infections, n=5 (83.33%). The most common AE of grade 3/4: infections, n=5 (83.3%). The most common type of infection was bacterial pneumonia. Of the 6 patients, cytokine release syndrome (CRS) occurred in 5 (83.3%) patients. All CRS events were grade 1 (83.33%) or grade 2 (16.66%), and no grade 3 or higher events were reported. 5 patients achieved sCR status. All 5 patients achieved CR within 6 weeks. 3 patients died of infection and 1 patient died of progressive disease. At last follow-up, 2 patients were alive and disease free. Elranatamab is a highly effective drug in the relapsed/refractory setting associated with a high rate of infections.