Elrexfio Maintains Responses in Aged, Frail Sufferers With A number of Myeloma

Amongst sufferers with relapsed/refractory a number of myeloma, a central evaluation of real-world Elrexfio (elranatamab-bcmm) was related to shorter occasions till illness development, or progression-free survival (PFS), however larger charges of response compared with real-world use of Tecvayli (teclistamab-cqyv), whereas sufferers within the Elrexfio cohort had much less favorable baseline traits, research findings have proven.

Findings had been offered on the 2025 American Society of Hematology Annual Assembly and Exposition.

“[Elrexfio] retains significant exercise in a frail, closely pretreated real-world inhabitants,” stated presenting research writer Dr. Andrew J. Portuguese, an assistant professor within the Medical Analysis Division and a doctor at Fred Hutch, and an assistant professor within the Division of Hematology and Oncology on the College of Washington Faculty of Drugs. “Regardless of its limitations, [Elrexfio] is a vital addition to our therapeutic armamentarium. Our information reinforce its effectiveness past the medical trial inhabitants and spotlight areas the place supportive care could enhance outcomes.”

Efficacy Noticed within the Actual-World Examine

The general response charge (ORR) with Elrexfio was 65% (81 of 125 sufferers), with a very-good partial response (VGPR) or higher charge of 46%, and a whole response (CR) or higher charge of 36%. These findings had been in contrast with cohort A of the part 3 MagnetisMM-3 trial, which discovered an ORR of 61%, a VGPR or higher charge of 56.1% and a CR or higher charge of 35%.^2,3

The median period of remedy was 4 months in all sufferers, although if a affected person had a VGPR or higher, it was 7.9 months. Therapy was discontinued by 12% of sufferers resulting from toxicity or non-relapse mortality; customers of intravenous immunoglobulin (IVIg) skilled a decrease charge of discontinuation than non-users (5% versus 17%).

With a median follow-up of seven.5 months within the offered dataset and 28.4 months within the cohort A of MagnetisMM-3 cohort, the median general survival (OS) was 14.6 months versus 24.6 months, respectively, the median PFS was 4.27 months versus 17.2 months and the median period of response (DOR) was 12.2 months versus not reached.

The one-year survival estimates had been much like what was noticed in a French compassionate-use cohort, with one-year OS charges of 42% versus 58%, respectively, one-year PFS charges of 34% versus 36% and one-year DOR charges of 48% versus 50%; the median DOR was 11 months versus 12.2 months. The French compassionate-use cohort included 101 sufferers and had a median follow-up of 15.5 months.

Moreover, survival with real-world Elrexfio was comparable for sufferers who had been trial-eligible and trial-ineligible.

Outcomes differed for sufferers based mostly on ECOG efficiency standing. Break up into teams of sufferers with an ECOG efficiency standing of 0 or 1, 2, or larger than 3, the median OS was not out there, not out there and a pair of.27 months, respectively; the median PFS was 6.53 months, 2.1 months and 1.08 months; and the median DOR was not out there, 11.7 months and 0.4 months.

Survival outcomes based mostly upon BCMA-naïve and BCMA-exposed standing had been additionally comparable.

Trial Breakdown

This evaluation included 130 sufferers who had been enrolled throughout 9 U.S. facilities from August 2023 to March 2025. The median age was 71 years, with 57% of sufferers being feminine, 82% being White and 48% having an ECOG efficiency standing of 1.The median variety of prior traces of remedy was six, 51% acquired prior autologous stem cell transplantation, 42% acquired prior CAR-T cell remedy and 89% had been refractory to anti-CD38.

Of the sufferers within the evaluation, 22% would have been eligible for cohort A of MagnetisMM-3.

Security

Concerning security, cytokine launch syndrome (CRS) occurred in 39% of sufferers, with 12% of occasions being grade 2 (reasonable) or larger and a pair of.3% being grade 3 (extreme) or larger; notably, this was much like cohort A of MagnetisMM-3. Immune-effector cell-associated neurotoxicity syndrome (ICANS) occurred in 17% of sufferers, with grade 2 or larger occasions occurring in 7.7%; the investigators famous that these charges had been larger than what was noticed in cohort A of MagnetisMM-3.

The median onset of CRS was two days, with a median period of 1 to 2 days. Actemra (tocilizumab) and steroids had been utilized by 36% and 23%, respectively, and an intensive-care unit keep was wanted by 6.2%.

Infections occurred in 38% of sufferers, with 57% being extreme, outlined as requiring hospitalization or intravenous antibiotics. IVIg was acquired by 46% of sufferers and was linked with decrease an infection danger. Notably, most extreme infections had been bacterial (71%), with viral (21%) and fungal (7.1%) infections being much less frequent.

Predictors of End result

It was discovered that larger lactate dehydrogenase (LDH) was related to worse PFS and OS; decrease hemoglobin was related to worse PFS and fewer doubtless CR and ECOG efficiency standing of two or larger was related to much less doubtless ORR. Prior BCMA publicity was related to a decrease CR or higher charge and a shorter OS if lower than one yr from prior BCMA. Basically, larger hemoglobin was related to higher outcomes, and better ferritin and LDH had been related to worse outcomes.

Reference

1. “Actual-world outcomes with elranatamab in a number of myeloma: A multi-center evaluation from the USA a number of myeloma immunotherapy consortium” by Dr. Andrew J. Portuguese et al., Blood.

For extra information on most cancers updates, analysis and training, don’t neglect to subscribe to CURE®’s newsletters right here.