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Elranatamab 在日本复发/难治性多发性骨髓瘤患者中的疗效:MagnetisMM-2 和 MagnetisMM-3 研究结果。

Elranatamab in Japanese patients with relapsed/refractory multiple myeloma: results from MagnetisMM-2 and MagnetisMM-3.

机构信息

Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8602, Japan.

Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Graduate School of Medicine, Yamagata, Japan.

出版信息

Jpn J Clin Oncol. 2024 Sep 4;54(9):991-1000. doi: 10.1093/jjco/hyae068.

Abstract

BACKGROUND

Despite advances, most patients with multiple myeloma (MM) experience relapse and repeat multiple treatment lines, highlighting an unmet need for patients with relapsed or refractory MM (RRMM). Bispecific antibodies are a new option, but their efficacy and safety in Japanese patients are unknown.

METHODS

This was an analysis of Japanese patients receiving elranatamab monotherapy in MagnetisMM-2 (NCT04798586) and MagnetisMM-3 (NCT04649359). Both studies evaluated a priming dose regimen of elranatamab followed by weekly subcutaneous doses, in patients with disease progression while receiving or who were intolerant to ≥3 prior therapies (≥1 proteasome inhibitor, ≥1 immunomodulatory drug and ≥1 anti-CD38 monoclonal antibody). The primary endpoints were dose limiting toxicities (DLTs) in MagnetisMM-2 and confirmed objective response rate (ORR) in MagnetisMM-3. In both, key secondary endpoints included safety, tolerability, duration of response, time to response, progression-free survival and overall survival.

RESULTS

In MagnetisMM-2 (N = 4) and MagnetisMM-3 (n = 12), median ages were 68.5 and 66.5 years, respectively. No DLTs were observed in MagnetisMM-2. ORRs were 50.0% (95% CI, 6.8-93.2) and 58.3% (95% CI, 27.7-84.8) in MagnetisMM-2 and MagnetisMM-3, respectively. All patients experienced treatment-emergent adverse events in MagnetisMM-2 (grade 3/4: 75.0%) and MagnetisMM-3 (grade 3/4: 100%); cytokine release syndrome occurred in 100% (grade 3/4: 25.0%) and 58.3% (no grade 3/4) of patients, respectively. Neither study reported immune effector cell-associated neurotoxicity syndrome.

CONCLUSIONS

No new safety signals were observed, and ORRs were similar to that of the overall MagnetisMM-3 trial population, supporting further studies of elranatamab in Japanese patients with RRMM. ClinicalTrials.gov identifier: NCT04798586 (MagnetisMM-2), NCT04649359 (MagnetisMM-3).

摘要

背景

尽管取得了进展,但大多数多发性骨髓瘤(MM)患者会复发并多次接受治疗,这突显了复发或难治性 MM(RRMM)患者存在未满足的需求。双特异性抗体是一种新的选择,但它们在日本患者中的疗效和安全性尚不清楚。

方法

这是一项对接受 Elranatamab 单药治疗的日本患者进行的分析,该分析来自 MagnetisMM-2(NCT04798586)和 MagnetisMM-3(NCT04649359)研究。两项研究均评估了 Elranatamab 的诱导剂量方案,随后每周皮下给药,用于疾病进展时正在接受治疗或不耐受≥3 种先前治疗(≥1 种蛋白酶体抑制剂、≥1 种免疫调节剂和≥1 种抗 CD38 单克隆抗体)的患者。主要终点是 MagnetisMM-2 中的剂量限制毒性(DLT)和 MagnetisMM-3 中的确认客观缓解率(ORR)。在这两项研究中,关键次要终点包括安全性、耐受性、缓解持续时间、反应时间、无进展生存期和总生存期。

结果

在 MagnetisMM-2(N=4)和 MagnetisMM-3(n=12)中,中位年龄分别为 68.5 岁和 66.5 岁。在 MagnetisMM-2 中未观察到 DLT。ORR 分别为 50.0%(95%CI,6.8-93.2)和 58.3%(95%CI,27.7-84.8)。在 MagnetisMM-2 和 MagnetisMM-3 中,所有患者均出现治疗相关不良事件(3/4 级:75.0%)和 MagnetisMM-3(3/4 级:100%);细胞因子释放综合征分别发生在 100%(3/4 级:25.0%)和 58.3%(无 3/4 级)的患者中。两项研究均未报告免疫效应细胞相关神经毒性综合征。

结论

未观察到新的安全性信号,ORR 与 MagnetisMM-3 总体试验人群相似,支持进一步研究 Elranatamab 在日本 RRMM 患者中的应用。临床试验.gov 标识符:NCT04798586(MagnetisMM-2),NCT04649359(MagnetisMM-3)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6d/11374885/51f3975af65c/hyae068f1.jpg

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