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ESC 2026 | Anselamimab in AL amyloidosis: efficacy and cardiac outcomes from the Phase III CARES trials
Xiaowen Wang, MD, Brigham and Women’s Hospital, Boston, MA, discusses findings from the Phase III CARES trials (NCT04512235, NCT04504825) evaluating anselamimab in light-chain (AL) amyloidosis. Prof. Wang reviews anselamimab’s novel mechanism of action, key efficacy findings, and promising improvements in cardiac structure and function in patients with κ light-chain disease. This interview took place during the 2026 European Society of Cardiology (ESC) Congress in Munich, Germany.
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Transcript
Yeah, so the current standard of care for AL amyloidosis is really chemotherapy, targeted immunotherapy, or in some cases, stem cell transplantation. It does not remove existing amyloids that are already deposited in vital organs, such as the heart. So the promise of anselamimab is that it actually removes the fibrils that are already deposited in the tissues. So it binds to the tissues, binds to the amyloid deposits, and then induces phagocytosis, or basically these proteins get taken up by the other cells...
Yeah, so the current standard of care for AL amyloidosis is really chemotherapy, targeted immunotherapy, or in some cases, stem cell transplantation. It does not remove existing amyloids that are already deposited in vital organs, such as the heart. So the promise of anselamimab is that it actually removes the fibrils that are already deposited in the tissues. So it binds to the tissues, binds to the amyloid deposits, and then induces phagocytosis, or basically these proteins get taken up by the other cells. So from that, we can potentially remove the amyloid from the heart and from other organs. Yeah, so the key clinical efficacy standpoints has actually been previously presented and published during the ASCO meeting earlier this year. And that showed that in the overall population, anselamimab did not actually reach their primary efficacy endpoint, which is the reduction in all-cause mortality and hospitalization from cardiovascular causes. But in a subgroup of patients, which is a kappa isotype, it actually showed very remarkable reduction in all-cause mortality as well as reduction in cardiovascular hospitalization compared to the placebo group. So in our analysis this time, we look at any changes in cardiac structure and function based on echocardiography. So what we did is that we look at echo at baseline and then at week 50, and we saw that there are several promising changes in cardiac structure and function. For example, there is a reduction in the wall thickness of the LV. There’s a reduction in LV mass. There’s also an increase in LV ejection fraction, which is a marker of the heart function. There are several markers that are functions of diastolic function, and those all improved as well. So I think overall, these are very, very promising results that kind of shows us some signals of why this might work and it also kind of again reaffirms the potential effect that we saw in terms of reduction in all-cause mortality as well as in cardiovascular hospitalizations.
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