Dr Mohty on the Real-World Efficacy of Elranatamab in R/R Multiple Myeloma

Mohamad Mohty, MD, PhD, professor, hematology, Sorbonne University, head, Clinical Hematology and Cellular Therapy Department, Saint-Antoine Hospital, discusses findings from the French compassionate use program evaluating the real-world efficacy of elranatamab-bcmm (Elrexfio) in patients with relapsed/refractory multiple myeloma.

This retrospective analysis assessed the efficacy and safety of elranatamab in 101 patients from 22 centers who received the agent between 2022 and 2023. Most of the patients observed in this study would have been considered ineligible for enrollment in the registrational, phase 2 MagnetisMM-3 trial (NCT04649359). Findings from this study supported the 2023 FDA approval of elranatamab monotherapy for the treatment of patients with relapsed/refractory multiple myeloma who have received 4 or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. Although the patient population observed in this study had unfavorable characteristics and disease features, at a median follow-up of 15.5 months (range, 3.4-18.8), the overall response rate (ORR) with elranatamab was 51.5%. This aligns with response rates that have been previously reported with the agent in more favorable patient populations, Mohty says. Importantly, 42% of these responses were very good partial responses (VGPRs) or better, which is encouraging to see since the quality of responses often correlates with improved outcomes, Mohty emphasizes. Furthermore, 22% of patients had a VGPR or better after 1 cycle of treatment.

Progression-free survival data from the study are difficult to assess, Mohty notes. He explains that this was not a clinical trial, so prespecified time to progression was not included. However, investigators were able to accurately assess duration of response (DOR), according to Mohty. The median DOR was 11 months (95% CI, 8-not assessed), and 48% of patients (95% CI, 31.1%-64%) had responses lasting at least 1 year. The 1-year overall survival rate was 42% (95% CI, 31.7%-52.1%). Overall, these study findings established the efficacy of elranatamab in this difficult-to-treat patient population, Mohty concludes.