Real-world outcomes with elranatamab for heavily pretreated RRMM

Real-world data from a retrospective, multicenter study by the U.S. Multiple Myeloma Immunotherapy Consortium, evaluating elranatamab for the treatment of relapsed/refractory multiple myeloma (RRMM; N = 130), were published in Blood Cancer Journal by Portuguese et al. Patients had a median of 6 prior lines of therapy (LoT); 91% were triple-class refractory and 49% had prior B-cell maturation antigen (BCMA)-targeted therapy. 

Key data: At a median follow-up of 7.5 months, the overall response rate (ORR) was 65%, including a complete response or better (≥CR) in 36%. Median progression-free survival (PFS) and overall survival (OS) were 4.3 months (95% confidence interval [CI], 3.4–11.3) and 14.6 months (95% CI, 8.6–not available [NA]), respectively. Median duration of response (DoR) was 12.2 months (95% CI, 6.1–NA). Intravenous immunoglobulin (IVIg) use was associated with prolonged infection-free survival (IFS) (adjusted hazard ratio [aHR], 0.46; 95% CI, 0.24–0.89; p = 0.021). Elevated lactate dehydrogenase (LDH) and low hemoglobin were independently associated with poorer outcomes and informed the Anemia-LDH Prognostic System (ALPS) score. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 40% and 17%, respectively.

Key learning: In the real-world setting, elranatamab demonstrated clinical activity in heavily pretreated RRMM, with baseline disease characteristics and IVIg use associated with clinical outcomes.