Early results from a phase 2 clinical trial suggest the bispecific antibody linvoseltamab can clear minimal residual disease in patients with multiple myeloma. The trial, led by Dickran Kazandjian of the Sylvester Comprehensive Cancer Center and conducted with C. Ola Landgren, was presented at the American Society of Hematology meeting in Orlando. The study enrolled 25 patients at Sylvester and its satellite sites in Coral Gables and Deerfield Beach; eighteen participants completed up to six treatment cycles.
Linvoseltamab binds CD3 on T cells and BCMA on myeloma cells, physically linking immune cells to cancer cells to boost tumour killing. Physicians then tested bone marrow with highly sensitive methods that can detect one cancer cell among a million normal cells. None of the 18 patients who finished treatment had detectable disease on those assays, a finding described as MRD-negative. Landgren noted that patients who are MRD-negative typically have longer relapse-free periods, while MRD-positive patients often receive high-dose chemotherapy and autologous stem-cell transplant, an approach he called intense and one after which myeloma often returns.
Some trial participants experienced side effects such as neutropenia and upper respiratory infections, but investigators judged the safety profile acceptable. The team also took steps to prevent cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome; no patients experienced those reactions. Based on these results, the researchers are expanding enrollment to 50 participants. Larger and longer studies will be required to confirm whether linvoseltamab can provide more durable disease control or a functional cure.
Difficult words
- bispecific antibody — protein that binds two different targets
- bone marrow — soft tissue inside bones where blood cells form
- minimal residual disease — small number of cancer cells left
- multiple myeloma — cancer of plasma cells in bone marrow
- autologous stem-cell transplant — procedure using patient's own stem cells
- neutropenia — low number of neutrophil white blood cells
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Discussion questions
- What would be the practical benefits for patients if linvoseltamab provides longer relapse-free periods or a functional cure?
- Why are larger and longer studies necessary after these early phase 2 results?
- How do steps to prevent cytokine release syndrome and neurotoxicity affect the safety of this treatment?
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