Thomas G. Martin, MD, spoke about the abstracts regarding B-cell maturation antigen–targeted treatments he’s excited to see presented at ASH 2021.
Ahead of the 2021 American Society of Hematology Annual Meeting (ASH), Thomas G. Martin, MD, associate director of the Myeloma Program at the University of California San Francisco, discussed the abstracts about therapies targeting B-cell maturation antigen (BCMA) that will be presented.
There’s also going to be a lot in the B-cell maturation antigen [BCMA] space. We’re going to get updates on BCMA-targeted T-cell engaging therapies. [REGN5458]1 is going to have an update and teclistamab [JNJ-64007957] will have an update.2 In the Regeneron study [of REGN5458], 68 patients [were] treated with 5 prior lines of therapy [and results] are going to show an overall response rate of about 73%. Teclistamab is going to [show] about 60% to 65%. These are single-agent antibody therapies. We’ve never seen these levels of responses as single agents. These are going to be moved up into earlier lines of therapy.
We’re also going to get some updates from some other CAR [T-cell therapy] studies, like bb2121.
Another interesting one is from Andrew Cowan, MD.3 He is going to give an update of their BCMA-directed CAR T-cell therapy together with a γ secretase inhibitor trying to increase expression of BCMA on the cell surface. They’re going to report on 18 patients [of whom] 7 had received prior BCMA-targeted therapy.2 One important question is can you give sequential BCMA-targeted therapies and what will they show. I am excited to see the data and see an overall response rate of 89% and a [median] PFS of about 11 months; we have to see how that splits up between prior BCMA or no prior BCMA therapy. They also had a significant amount of [patients with] cytokine release syndrome, about 95%, which is what we see for CAR T-cell therapy. What stood out for me was they had an ICANS [immune effector cell-associated neurotoxicity syndrome] rate of 66%. I’m curious to see what that’s going to look like and why there’s more neurotoxicity when a γ secretase inhibitor is used, so we look forward to having those discussions.
1. Zonder J, Richter J, Bumma N, et al. Early, Deep, and Durable Responses, and Low Rates of Cytokine Release Syndrome with REGN5458, a BCMAxCD3 Bispecific Monoclonal Antibody, in a Phase 1/2 First-in-Human Study in Patients with Relapsed/Refractory Multiple Myeloma (RRMM). Presented at: 63rd American Society of Hematology Annual Meeting; December 11-13, 2021; Atlanta, GA. Accessed December 8, 2021. https://bit.ly/3lLyGWW
2. Moreau P, Usmani S, Garfall A, et al. Updated results from MajesTEC-1: Phase 1/2 study of teclistamab, a B-cell maturation antigen x CD3 bispecific antibody, in relapsed/refractory multiple myeloma. Presented at: 63rd American Society of Hematology Annual Meeting; December 11-13, 2021; Atlanta, GA. Accessed December 2, 2021. https://bit.ly/32Om8aB
3. Cowan A, Pont M, Sather B, et al. Safety and efficacy of fully human BCMA CAR T cells in combination with a gamma secretase inhibitor to increase BCMA surface expression in patients with relapsed or refractory multiple myeloma. Presented at: 63rd American Society of Hematology Annual Meeting; December 11-13, 2021; Atlanta, GA. Accessed December 2, 2021. https://bit.ly/3G6iSpy