A novel, immunotherapy-based approach for the treatment of relapsed/refractory multiple myeloma (RRMM): Updated phase 1b results for daratumumab in combination with teclistamab (a BCMA x CD3 bispecific antibody).

Authors

Paula Rodríguez-Otero

Paula Rodríguez-Otero

Clínica Universidad de Navarra, Madrid, Spain

Paula Rodríguez-Otero , Anita D'Souza , Donna Ellen Reece , Niels W.C.J. van de Donk , Ajai Chari , Amrita Y. Krishnan , Thomas G. Martin , Maria-Victoria Mateos , Daniel Morillo , David Duane Hurd , Laura Rosiñol , Anna Sureda Balari , Ralph Wäsch , Deeksha Vishwamitra , Shun Xin Wang Lin , Thomas Prior , Lien Vandenberk , Marie-Anne Damiette Smit , Albert Oriol Rocafiguera , Bhagirathbhai R. Dholaria

Organizations

Clínica Universidad de Navarra, Madrid, Spain, Medical College of Wisconsin, Milwaukee, WI, Princess Margaret Cancer Centre, Toronto, ON, Canada, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands, Mount Sinai School of Medicine, New York, NY, City of Hope Comprehensive Cancer Center, Duarte, CA, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, University Hospital of Salamanca/IBSAL/CIC/CIBERONC, Salamanca, Spain, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain, Comprehensive Cancer Center of Wake Forest Baptist Health, Winston Salem, NC, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain, Institut Català d'Oncologia – Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain, Freiburg University Medical Center, Freiburg, Germany, Janssen Research and Development, Spring House, PA, Janssen Research & Development, Antwerp, Belgium, Janssen Research & Development, Los Angeles, CA, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain, Vanderbilt University Medical Center, Nashville, TN

Research Funding

Pharmaceutical/Biotech Company

Background: Teclistamab (tec; JNJ-64007957) is a BCMA × CD3 T-cell redirecting bispecific antibody under investigation in patients (pts) with RRMM. Daratumumab (dara) is a CD38 mAb with direct on-tumor and immunomodulatory actions. Initial clinical data from the phase 1b multicohort TRIMM-2 study support the combination of tec + dara for the treatment of RRMM, with tolerable safety, no overlapping toxicities, and promising efficacy. We present updated results with additional pts and longer follow-up. Methods: Eligible MM pts aged ≥18 y had received ≥3 prior lines of therapy (LOT; including a proteosome inhibitor [PI] and immunomodulatory drug [IMiD]) or were double-refractory to a PI and IMiD. Pts treated with anti-CD38 therapy ≤90 d prior were excluded. Pts received dara SC 1800 mg per approved schedule and tec SC 1.5–3 mg/kg QW or Q2W. Primary objectives were to identify the recommended phase 2 dose of tec for combination therapy and evaluate safety of the combination. Responses were assessed by IMWG criteria. AEs were graded per CTCAE v5.0; cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) were graded per ASTCT guidelines. Results: At data cutoff (Jan 13, 2022; safety population: N=46), median follow-up was 7.2 mo (range 0.1–16.6; median age 67 y [range 50–79]; 52% female). Pts received a median of 6 prior LOT (range 2–17; 74% triple-class exposed; 63% penta-drug exposed; 15% anti-BCMA exposed). 91% of pts had ≥1 AE (grade 3/4 78%), most commonly CRS (61%; all grade 1/2; median time to onset 2 d; median duration 2 d), neutropenia (54%; grade 3/4 50%), anemia (46%; grade 3/4 28%), thrombocytopenia (33%; grade 3/4 28%), and diarrhea (33%; grade 3/4 2%). Infections occurred in 29 pts (63%; grade 3/4 28%). One pt had grade 1 ICANS that fully resolved. Among 37 response-evaluable pts, ORR was 78% (29/37); 27 pts (73%) had very good partial response (VGPR) or better (Table). Median time to first response across dosing cohorts was 1.0 mo (range 0.9–2.8); median duration of response was not reached. Upregulation of CD38+/CD8+ T cells and proinflammatory cytokines was observed with tec + dara, supporting potential synergy of the combination in pts with prior anti-CD38 exposure. Updated results will be presented. Conclusions: Tec + dara provides a novel immunotherapy approach for the treatment of RRMM that may yield improved clinical efficacy in heavily pretreated pts. Clinical trial information: NCT04108195.

Responses in evaluable ptsa in tec + dara cohorts.


Dara 1800 mg +

Tec 1.5 mg/kg QW

(n=20)b
Dara 1800 mg +

Tec 3 mg/kg QW

(n=4)
Dara 1800 mg +

Tec 3 mg/kg Q2W

(n=13)
Overall response, n
15
4
10
VGPR or better, n
14
4
9
Complete response or better, n
6
2
1

aPts who received ≥1 study treatment and had ≥1 postbaseline response evaluation. b8 pts switched to tec 3 mg/kg Q2W (3 at cycle [C] 4, 3 at C5, 1 at C7, and 1 at C9).

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT04108195

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 8032)

DOI

10.1200/JCO.2022.40.16_suppl.8032

Abstract #

8032

Poster Bd #

456

Abstract Disclosures