SOHO 2026 | Anselamimab in AL amyloidosis: combining and sequencing with plasma cell-directed treatment

So I think there are two parts to amyloidosis. One is the production of the monoclonal protein, which is where the anti-plasma cell therapy comes along. We have to reduce the production of the monoclonal protein, but then we also have to target the organ deposits, which is where anselamimab comes along. And we have to use these therapies in combination or in sequence, and this is the first time ever an antifibril antibody has been shown to improve survival in any type of amyloidosis, and certainly so in AL amyloidosis. So we will need to learn a bit more about exactly how we sequence this. But we have to reduce the production of the monoclonal protein, without which the antibody can’t really clear the amyloid protein deposits, because you still have the monoclonal protein without which the antibody can’t really clear the amyloid protein deposits because you still have the monoclonal light chains in the serum, they will still continue to form amyloid deposits even if the antibody clears deposits, new deposits will be formed immediately. So the combination strategy has to be used and the combination is a highly effective anti-plasma cell directed therapy to reduce or eliminate the production of the monoclonal protein, and then an antifibril strategy to actually clear the protein deposits from the organs to allow improvement in end-organ function. So anselamimab will always have to be used in combination with an anti-plasma cell therapy, whether it be daratumumab or something else. Now, patients who have already been pre-treated and have achieved a good response but continue to have end-organ dysfunction also have a potential to benefit from this therapy because they still have organ dysfunction from amyloid, but they’re not actually producing new deposits. So potentially, this antibody could be used in such patients to help them to clear the amyloid deposits faster when the production problem has been eliminated. But if we look into the future, if this is licensed, then for patients with kappa-light-chain amyloidosis, one would use it in combination with an anti-plasma cell directed therapy right from the outset because the sooner you can start targeting the deposits, the sooner you stop the damage, the sooner you reverse the damage. And then you would potentially continue the treatment until you had evidence of resolution of the deposits.

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