Rafael Fonseca, MD, Talks Future of Multiple Myeloma With Off-the-Shelf Cellular Therapies

Rafael Fonseca, MD, spoke about how bispecific antibodies like elranatamab have the potential to change the treatment paradigm for patients with relapsed/refractory multiple myeloma.

At the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® spoke with Rafael Fonseca, MD, director for Innovation and Transformational Relationships at the Mayo Clinic’s campus in Phoenix, Arizona, who . Fonesca discussed the use of elranatamab as a potential future treatment option for patients with relapsed/refractory multiple myeloma. Elranatamab was is being analyzed in the ongoing phase 2 MagnetisMM-9 trial (NCT05014412) for patients with relapsed/refractory multiple myeloma. Additionally, the trial set out to determine how to best mitigate cytokine release syndrome in this patient population.


The advent of bispecific antibodies is dramatically changing dramatically in how we start to think about the treatment of multiple myeloma. We’ve been very lucky to have 2 CAR T-cell therapies approved [for multiple myeloma] by the FDA over the past year and a half, but t. This is still is not sufficient. There are’s some challenges with CAR T-cell therapys because you have to manufacture the product, and you have to re-infuse the cells. There’s somewhat limited access right now. Everyone is excited about the idea of having an off-the-shelf product, something where I could see in[that allows us to see] the patient in the morning, and then in the afternoon, the patient could be receiving the treatment. It’s going to be interesting to see how that plays out. We have incredible results with some of the CAR T-cell therapies. If you look at the data with cilta-cel [ciltacabtagene autoleucel; Carvykti], most patients respond. The reality is [that this therapy is] not available for all patients and under because of certain complexities and the time it takes to get the product manufactured and then re-infused back to the patient, which makes the bispecifics attractive.


Fonseca R, Kuroda J, Ishida, et al. MagnetisMM-9: An open-label, multicenter, non-randomized phase 1/2 study of elranatamab in patients with relapsed/refractory multiple myeloma. J Clin Oncol. 2022;40(suppl 16):TPS8068. doi:10.1200/JCO.2022.40.16_suppl.TPS8068