EHA 2023 | Ongoing studies of elranatamab in frail patients & with DaraPomDex: MagnetisMM-3 & MagnetisMM-5

We have on behalf of the other authors and the Pharma company Pfizer, two abstracts to EHA 2023 to share experience with elranatamab bispecific anti-BCMA, anti-cd3. The first abstract speaks about an issue we face in real life, which is that in clinical trials there’s a lot of subgroups of patients from the real life that are not represented and most of the time the frail patients, whatever frail definition is, are not represented in clinical trial. So it was important to report on how much the bispecific anti-BCMA, anti-CD3 such as elranatamab could be given to patients that are frail. Can it be given? Are the results as good as for non frail patients? Can you can you can you give this drug, this immunotherapy to patients for a long period of run, safe in the short run but also safe in in the mid and long term and and how much you can manage the I would say most two important adverse events that we have reported with bispecifics the CRS initially, cytokine release syndrome and infectious issues most recently reported with the use of anti-CD3 bispecific. The abstracts and for all of those who can attend EHA, the poster will report on the feasibility of giving anti-CD3, anti-BCMA bispecific such as elranatamab to frail patients elderly patients and though the time on treatment, the true efficacy benefit, response rate is is slightly lower than non frail patients overall it’s manageable I would like to put it together it’s feasible, and benefits to the patients and so it was it was a great subanalysis to to to be able to demonstrate that probably all patients can receive an anti-BCMA, anti-CD3 bispecific such as elranatamab, including many of the population that are not necessarily represented in clinical trials. The second abstract was more like a TIP, what we call a trial in progress, which is an abstract to outline where are we going with the bispecific anti-BCMA, anti-CD3 such as elranatamab. Are they going to be used only in end stage myeloma where we have demonstrated they have an incredible activity or are they going to be used earlier in the disease course of the patients where we believe that the activity will be even more genius? And so we report on MagnetisMM-5, which is a Phase III trial for registration, sponsor Pfizer company, where the control arm is daratumumab-pomalidomide-dexamethasone, one of the standards of care in early relapse in the relapsed setting for myeloma patients versus compared to the bispecific so elranatamab either monotherapy or in combination with daratumumab. It’s an ongoing, recruiting clinical trial. To me it’s an extremely exciting clinical trial, first of all, because it gives a chance for patients in second or third line to get access early relapse to get access to the bispecific antibodies such as elranatamab and really, I hope, we get a chance to have a very prolonged survival thanks to the fact that they were able to get these drugs early on in the disease course when the immune system is not too much exhausted and there is ample discussion around that. And it’s also a great option, a great opportunity, because I think for the patients because we know these all these regimens we have now Anti-cd38, pomalidomide or carfilzomib, they are very good, but the median PFS is around two to three years and we need to do better. So we don’t know if the bispecific will do better, but we need to dream that we can do better. And so I think MagnetisMM-5 in that extent is one of the studies that I hope will demonstrate that potentially in the early relapse they will become the standard of care, the new drugs, the drug to use to have the patient survive later on. One thing interesting with MagnetisMM-5 before I close that, is that the drug will be used monotherapy or in combination with daratumumab, which gives us a chance to appreciate if potentially for some patients it will be better in monotherapy and for others better in combination with daratumumab. That’s still something we need to look into and appreciate. It’s not done actually because we have started using those bispecific upfront now and not only post-transplant or not only trying to replace transplant but also in non transplant-eligible patients, which is what I’m in charge of in my scientific society, the Intergroup Francophone on Myeloma where we are trying to put together clinical trials to improve on the MAIA, daratumumab lenalidomide, dexamethasone, new backbone, incredible backbone trying to do better, keeping the immunology effect, having more MRD-negative responses and and we believe that the bispecific antibody anti-BCMA, anti-CD3 can do it and so stay tuned because soon we might report on the use of these bispecifics in that setting upfront for newly diagnosed but non transplant-eligible patients. Thank you very much.