ASH 2023 | ImmunoPRISM: a platform study investigating bispecific antibodies in smoldering multiple myeloma

What we have been trying to say is we can use immunotherapy as early as possible, because it makes sense when your immune system is still intact, when you still have excellent T-cells and they’re not exhausted or used up by all of the therapies that we’ve had before and when you have less tumor burden, this is the best time to really harness your own immune system, to kill the cancer cells. And to prove that, we started the clinical trial of ImmunoPRISM, where we’re asking the question, can we use bispecific antibodies compared to lenalidomide and dexamethasone, which is the standard of care that we use in high risk smoldering myeloma. 

So it’s a platform study where we can ask any bispecific question to be added into that platform, and we started with Teclistamab. And indeed we found an impressive response rate of 100% MRD-negative disease ten to the six, which is really one of the unique opportunities to see such a response in this patient population. Even when they have a high tumor burden, we still were able to get impressive responses and the responses happen very fast. So MRD-negative disease was happening at a median of four and a half months in our patients, and it’s durable so far. Again, we need long-term outcomes to see how long this will last, and will it be MRD-negative for years to come, which could potentially indicate cure in the future. But also what was very interesting is we have less toxicity and less infections compared to what we see in the relapsed setting. And maybe that’s again an opportunity to say that the immune system is still relatively intact, and therefore those patients are not so immunosuppressed that they will have all of the opportunistic infections. So again, it’s early data, but very promising data to ask the question of: is immunotherapy the right way to do it as early as possible in patients with multiple myeloma?