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EHA 2026 | The clinical efficacy of bexmarilimab and azacitidine in HR-MDS: current data and future outlooks
Mika Kontro, MD, PhD, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland, shares insights into the clinical efficacy of bexmarilimab in combination with azacitidine for patients with higher-risk myelodysplastic syndromes (HR-MDS). He discusses the mechanism of action of bexmarilimab and highlights results from the BEXMAB trial (NCT05428969). This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
First of all, starting, what is bexmarilimab? So Clever-1 is actually an immunosuppressive molecule that is expressed on the macrophages and monocytes. With bexmarilimab we can actually target Clever-1 and basically that leads to enhanced antigen presentation, enhanced HLA-DR expression and also T-cell activation and cytokine production. And in the BEXMAB trial that we conducted, which was a phase I/II trial, we actually included 20 patients with previously untreated high-risk MDS and 32 patients with HMA-failed MDS...
First of all, starting, what is bexmarilimab? So Clever-1 is actually an immunosuppressive molecule that is expressed on the macrophages and monocytes. With bexmarilimab we can actually target Clever-1 and basically that leads to enhanced antigen presentation, enhanced HLA-DR expression and also T-cell activation and cytokine production. And in the BEXMAB trial that we conducted, which was a phase I/II trial, we actually included 20 patients with previously untreated high-risk MDS and 32 patients with HMA-failed MDS. We have some updates on the results regarding the frontline patient population. 45% of the patients achieved CR responses, and we have now updated the duration of CR. The median duration is 16 months. When looking at HMA failed patient population, the overall survival median is 14.5 months, so it continues to hold strong. And then for a patient population, the overall response rate is 64%. So basically what we actually presented at this meeting, we wanted to evaluate that what’s happening in the patients when we are treating them with azacitidine and bexmarilimab. First of all, based on the single cell RNA sequencing data and spectral flow, we were capable of showing that, first of all, quite interestingly, we see elevation of erythroid progenitor cells, and perhaps that might also translate to hematologic improvements. In addition to that, we actually also saw quite interesting differences in T-cell populations comparing the responders and non-responders. So for responders, we observed that these patients actually had more central memory T-cells, whereas non-responders had increased amounts of T-cells that were kind of exhausted. And perhaps these actually can be then validated later on in the upcoming Phase IIb trial, which will be a global trial recruiting patients for frontline population across the globe.
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