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Dr Krishnan on Elranatamab Plus Daratumumab/Lenalidomide in Newly Diagnosed, Transplant-Ineligible Multiple Myeloma

Amrita Krishnan, MD, discusses data for elranatamab plus daratumumab and lenalidomide in newly diagnosed, transplant-ineligible multiple myeloma.

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    “These results suggest that a BCMA-directed bispecific [antibody] can be administered in newly diagnosed patients and yield higher response rates than typically observed in the relapsed/refractory setting.”

    Amrita Krishnan, MD, the Nason-Hollingsworth Endowed Chair for Multiple Myeloma, director of the Judy and Bernard Briskin Multiple Myeloma Center, and a professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, as well as executive medical director of Hematology at City of Hope Orange County, shared insights regarding preliminary safety and efficacy findings from part 1 of the phase 3 MagnetisMM-6 trial (NCT05623020), which is evaluating the BCMA-directed bispecific antibody elranatamab-bcmm (Elrexfio) in combination with daratumumab (Darzalex) and lenalidomide (Revlimid) in patients with newly diagnosed multiple myeloma who are ineligible for transplant.

    Data presented at the 2025 ASCO Annual Meeting showed that the combination regimen (n = 34) induced a confirmed overall response rate (ORR) of 97.3% (95% CI, 85.8%-99.9%) at the April 1, 2025, data cutoff. At a median follow-up of 7.9 months (range, 1.2-9.5), 94.6% of patients achieved a very good partial response (VGPR) or better, and 27.0% experienced a complete response (CR) or stringent CR (sCR). Median time to response was 1.5 months (range, 0.3-4.2), and responses deepened over time; the sCR rate increased from 2.7% at an earlier 4.6-month follow-up to 8.1% in the updated analysis.

    Krishnan noted that the cohort included a significant proportion (24.3%) of frail patients, underscoring the regimen’s feasibility in older or more vulnerable populations. She also highlighted the manageable safety profile, with the rate of grade 3/4 infections comparable to that observed with daratumumab, lenalidomide, and dexamethasone. Improved supportive care and growing clinical experience with bispecific antibodies likely contributed to these favorable tolerability outcomes, she added. Krishnan underscored the role of prophylaxis and vigilant infection monitoring to further mitigate risk.


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