Commentary

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Dr Richter on Ongoing Research With Bispecific Antibodies in R/R Multiple Myeloma

Joshua Richter, MD, discusses ongoing or upcoming research with bispecific antibodies in relapsed/refractory multiple myeloma.

Joshua Richter, MD, associate professor of Medicine, the Division of Hematology and Medical Oncology, Tisch Cancer Institute, and director of Multiple Myeloma, Blavatnik Family Chelsea Medical Center, Mount Sinai, discusses ongoing or upcoming research efforts examining bispecific antibodies in earlier lines of therapy for patients with relapsed/refractory multiple myeloma.

Several studies are investigating bispecific antibodies as monotherapies and in combination regimens in earlier lines of treatment, Richter begins. For example, the phase 1 TRIMM-2 trial (NCT04108195) and the phase 1 TRIMM-3 (NCT05338775) studies are exploring various combinations featuring bispecific antibodies, aiming to enhance treatment efficacy, Richter reports. TRIMM-2 is evaluating subcutaneous daratumumab (Darzalex) plus the bispecific T-cell engager talquetamab (Talvey) in patients with relapsed/refractory multiple myeloma, and TRIMM-3 is investigating the addition of a PD-1 inhibitor to either talquetamab or teclistamab (Tecvayli) in this disease setting.

Efforts to improve the patient experience with these drugs in the community setting are also underway, Richter continues. Studies have examined the use of prophylactic tocilizumab (Actemra) to reduce the incidence of cytokine release syndrome (CRS), potentially allowing for the administration of these drugs on an outpatient basis, Richter explains. This was observed in the E-1 cohort of the phase 1 CaMMouflage study (NCT05722418) as well as in specific cohorts of the phase 2 MajesTEC-1 study (NCT0455709), he adds.

Additionally, investigations of the non–BCMA-targeting bispecific antibody cevostamab (RG 6160) include the evaluation of limited-duration treatment regimens, Richter notes. Similarly, an investigator-initiated phase 2 trial (NCT05932680) led by Alfred Garfall, MD, of the University of Pennsylvania, is assessing the efficacy of teclistamab (Tecvayli) with shorter treatment durations, he adds.

Overall, implementing prophylactic tocilizumab and exploring limited-duration approaches may make bispecific antibodies more accessible and manageable for community-based oncologists, potentially improving treatment delivery and patient outcomes in diverse clinical settings, Richter concludes.

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