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Weisel, Katja C

0000-0001-9422-6614

Mayo Clinic

University Medical Center Hamburg-Eppendorf

Citations 76

Comparative Effectiveness of Linvoseltamab Versus Current Real-World (RW) Standard-of-Care (SOC) Therapies in Triple-Class Exposed Relapsed/Refractory Multiple Myeloma (RRMM): Key Subgroups Analysis
Kumar, Shaji, Dachs, Laura Rosiñol, Leleu, Xavier , Rubia, Javier de la , Mateos, María‐Victoria , Martínez, Borja Puertas, Gozzetti, Alessandro , Bladé, Joan , Beksaç, Meral , Escalante, Fernando , Nagaraj, Madhu , Hassan, Rafla , Spin, Paul , Bonar, Nicolle , Siddiqui, Muhaimen, Hou, Kevin, Green, Jeannette, Breskin, Alexander , Harnett, James , Ge, Wenzhen , Jalbert, Jessica J. , Kroog, Glenn S. , Lorenc, Karen Rodriguez , Ma, Qiufei , Durie, Brian G.M. , Gozzetti, Alessandro , Kumar, Shaji , Jagannath, Sundar , Weisel, Katja C , Dimopoulos, Meletios Α. , Siegel, David S. , Monge, Jorge , Du, Juan , Lee, Jae Hoon , Puertas, Borja , Dytfeld, Dominik , Ocio, Enrique M. , Ozaki, Shuji , Shokoohi, Mostafa , Wang, Di, Humblet, Olivier , Sobel, Rachel E. , Hampp, Christian

Blood | December 5, 2024 | Volume: 144 | Issue: Supplement 1 | Pages: 7012-7012

10.1182/blood-2024-200679 Get It

Introduction Linvoseltamab is an investigational, BCMA×CD3 bispecific antibody designed for the treatment of RRMM. High objective response rates (ORR) to linvoseltamab 200 mg in the LINKER-MM1 trial (NCT03761108) were demonstrated across high-risk subgroups, including patients aged ≥75 years, patients with high-risk cytogenetics, and patients with penta-class refractory status. The aim of this study was to compare ORR, overall and in key subgroups, between patients in Phase 2 of the LINKER-MM1 trial and patients in an international RW SOC external control arm (ECA). Methods The ECA was derived from a chart review of 16 academic sites across 10 countries that are part of the International Myeloma Foundation (IMF)-International Myeloma Working Group (IMWG) and 2 US electronic health record databases (COTA and Guardian Research Network [GRN]). Included patients initiated ≥1 anti-MM treatment after meeting key eligibility criteria of LINKER-MM1. Weighted random sampling and inverse probability of treatment weighting (IPTW) were used to select 1 line of therapy (LOT) per patient and balance the overall ECA and trial populations on prespecified prognostic factors (Kumar S, et al. IMS 2023). For ORR assessment, LINKER-MM1 and IMF-IMWG used independent central review committees per IMWG criteria, COTA used algorithmic assessment based on IMWG criteria, and GRN used physician-assessed responses. Prior to conducting comparative analyses, an independent committee of epidemiology and oncology experts reviewed the comparability of the cohorts and endpoint assessments, and approved study continuation. ORR among patients in LINKER-MM1 and patients in the ECA was compared overall and across prespecified subgroups (≥10 patients per subgroup), including age, race, cytogenetic risk score, international Staging System (ISS), presence of extramedullary plasmacytoma (EMP), refractory class, bone marrow plasma cell (BMPC) proportion, and number of prior LOTs. Results Median duration of follow-up was 14.3 months (data cut-off: January 6, 2024) for patients receiving linvoseltamab (n=105) and 13.6 months for the ECA (n=307; n=194, n=72, and n=41 from IMF-IMWG, COTA, and GRN, respectively). Following IPTW, 13 prognostic factors with <30% missingness were balanced between cohorts, with an effective sample size in the ECA of 197. After adjustment, ORR was significantly higher in patients who received linvoseltamab compared with patients in the ECA (69.5% vs 45.7%, odds ratio [OR] 2.5 [95% confidence interval (CI) 1.6-4.1]) and in key subgroups with age 65-74 years (76.9% vs 48.3%, OR 3.6 [1.6-8.6]), age ≥75 years (72.4% vs 48.5%, OR 2.8 [1.1-7.4]), Black or African American race (82.4% vs 25.0%, OR 14.0 [3.0-85.4]), White race (68.9% vs 49.7%, OR 2.2 [1.3-4.0]), standard cytogenetic risk (72.3% vs 51.3%, OR 2.5 [1.3-4.8]), ISS stage III (58.8% vs 19.7%, OR 5.8 [1.5-25.2]), absence of EMP (71.6% vs 49.3%, OR 2.6 [1.5-4.6]), triple-class refractory status (68.2% vs 45.7%, OR 2.6 [1.5-4.4]), quadruple-class refractory status (66.7% vs 45.9%, OR 2.4 [1.3-4.3]), 4-5 prior LOTs (65.1% vs 40.4%, OR 2.8 [1.3-6.0]), and >5 prior LOTs (75.7% vs 36.1%, OR 5.5 [2.4-13.6]). Numerically higher (not statistically significant) or similar ORR was observed for patients receiving linvoseltamab compared with patients in the ECA with age <65 years (59.5% vs 46.8%, OR 1.7 [0.79-3.6]), high-risk cytogenetics (65.0% vs 63.1%, OR 1.1 [0.41-2.9]), ISS stage I (73.3% vs 64.6%, OR 1.5 [0.62-3.7]), ISS stage II (67.6% vs 53.5%, OR 1.8 [0.72-4.7]), presence of EMP (58.8% vs 56.9%, OR 1.1 [0.32-3.8]), penta-class refractory status (64.3% vs 48.5%, OR 1.9 [0.78-4.8]), BMPC <50% (77.0% vs 67.2%, OR 1.6 [0.61-4.3]), BMPC ≥50% (41.7% vs 36.0%, OR 1.3 [0.36-4.7]), and ≤3 prior LOTs (68.0% vs 66.4%, OR 1.1 [0.43-2.9]). Separate findings will be presented for IMF-IMWG and COTA/GRN data at the congress. Conclusions Linvoseltamab induced better ORR vs RW SOC treatments overall, and better or similar ORR in the key subgroups assessed, highlighting its therapeutic value across a range of patients with RRMM with heterogeneous risk profiles and levels of disease burden.
Correlative biomarker analyses for optimal therapeutic dose determination of ABBV-383, a B-cell maturation antigen (BCMA) x CD3 bispecific antibody, in patients with relapsed/refractory multiple myeloma (RRMM).
Ahsan, Aarif, Mantis, Christine, Luo, Xizhi, Zhang, Catherine, Valdes, Cesar Rodriguez , Voorhees, Peter M. , Safah, Hana, McKay, John T., Korde, Neha , Vij, Ravi , Kumar, Shaji , Bueno, Orlando Felix, Pothacamury, Rajvineeth Kumar, D’Souza, Anita , Chung, Alfred , Tuchman, Sascha Alexander , McKay, John, Weisel, Katja C , Teipel, Raphael , Bueno, Orlando F. , Talati, Chetasi , Ross, Jeremy A.

Journal of Clinical Oncology | June 10, 2024 | Volume: 42 | Issue: 16_suppl | Pages: 7532-7532

10.1200/jco.2024.42.16_suppl.7532 Get It

7532 Background: ABBV-383 is a BCMA x CD3 bispecific antibody with 2 high-affinity BCMA-binding domains and a low-affinity CD3 engaging arm that has been shown to decrease the negative impact of soluble BCMA (sBCMA) and drive sustained T-cell activation with reduced cytokine release in preclinical models of MM. Here, we describe correlative biomarker results of baseline and longitudinal sBCMA levels and immune profiles in the ongoing first-in-human trial that supports 60 mg Q4W as the optimal therapeutic dose of ABBV-383 monotherapy. Methods: Peripheral blood and serum samples from patients with RRMM enrolled in the phase 1 open-label, dose-expansion study (NCT03933735) who received ABBV-383 at 20, 40, or 60 mg Q3W or 60 mg Q4W were collected at baseline (post-dexamethasone, pre–ABBV-383), on treatment, and at disease progression. Samples were analyzed by flow cytometry for immune cell populations, Luminex for cytokines, and electrochemiluminescence ligand binding for sBCMA. Results: Median sBCMA levels at baseline were highly variable among patients, but did not associate with clinical response (≥ partial response [PR]) to ABBV-383 at the selected optimal dose level of 60 mg Q4W (<PR: 244.7 ng/mL; ≥PR: 52.2 ng/mL; P=0.13). Reduction in sBCMA levels over time associated with clinical response (Cmin at cycle 5: <PR, 244.7 ng/mL; ≥PR, 4.7 ng/mL; P=0.04). ABBV-383 treatment led to a rapid and transient increase of proinflammatory cytokines, including IL-6, IL-8, IL-10, TNF-α (Cmax within cycle 1: 29, 349.5, 1375, 456.5 pg/mL, respectively), and promoted T-cell redistribution (89% reduction of CD8+ T cells from periphery), activation (1.9-fold increase in CD69+CD8+ T cells), and proliferation (2-fold increase in Ki67+CD8+ T cells) within cycle 1 in 60-mg Q4W-treated patients. The frequency of baseline CD8+ T-cell exhaustion (PD-1/TIM3) did not impact clinical response at the optimal dose level of 60 mg Q4W ABBV-383 (<PR: 3.5%; ≥PR: 3.9%; P=0.9). Peak induction levels of proinflammatory cytokines during cycle 1 correlated with occurrence of cytokine release syndrome (≥G1) as well as clinical response across dose levels. Conclusions: High-avidity BCMA binding coupled to low-affinity T-cell engagement distinguishes the resulting mechanism of action for ABBV-383. Responses to 60 mg Q4W ABBV-383 were independent of baseline sBCMA levels and resulted in rapid and transient proinflammatory cytokine production that promoted robust T-cell redistribution, activation, and proliferation, indicating that the optimal dose of ABBV-383 maximizes its clinical potential as a convenient, safe, and effective therapy for MM. Clinical trial information: NCT03933735 .
Efficacy, safety, and determination of RP2D of ABBV-383, a BCMA bispecific antibody, in patients with relapsed/refractory multiple myeloma (RRMM).
Valdes, Cesar Rodriguez , Voorhees, Peter M. , Safah, Hana, McKay, John T., Korde, Neha , Vij, Ravi, Bueno, Orlando Felix, Rosenberg, Tanya, Pothacamury, Rajvineeth Kumar, Polepally, Akshanth, Ahsan, Aarif, Kumar, Shaji , D’Souza, Anita , Chung, Alfred , Tuchman, Sascha Alexander , McKay, John, Weisel, Katja C , Teipel, Raphael , Bueno, Orlando F. , (Lee), Xin (Shane) Li, Jin, Ziyi , Talati, Chetasi

Journal of Clinical Oncology | June 10, 2024 | Volume: 42 | Issue: 16_suppl | Pages: 7531-7531

10.1200/jco.2024.42.16_suppl.7531 Get It

7531 Background: MM eventually becomes refractory to current treatments, and new therapeutic options with convenient dosing and improved safety are needed to enhance patient (pt) adherence, access, and outcomes. ABBV-383 is a distinctive next-generation BCMA x CD3 bispecific antibody composed of 2 high-affinity BCMA-binding domains, a low-affinity CD3-binding domain designed to reduce cytokine release syndrome (CRS) risk, and a silenced Fc tail for an extended half-life allowing convenient dosing. ABBV-383 monotherapy has shown promising activity in the ongoing first-in-human phase 1 trial in RRMM (Vij et al. Blood 2023;142[suppl 1]:3378). Here, safety and efficacy results are reported that support the RP2D of 60mg Q4W as the optimal therapeutic ABBV-383 monotherapy dose. Methods: This phase 1 open-label, dose-escalation/expansion trial (NCT03933735) enrolled pts with RRMM who received ≥3 prior lines of therapy with exposure to PI, IMiD, and anti-CD38 mAb. ABBV-383 regimens explored in the expansion phase included 60mg Q4W and 40 or 60mg Q3W. A modified dexamethasone premedication schedule and shortened CRS monitoring period were implemented in the 60mg Q4W cohort for cycle 1. IV ABBV-383 was administered as a flat dose with no step-up schedule. Treatment was continued until disease progression/unacceptable toxicity. Primary objectives were to assess safety, tolerability, PK, PD, and determine the RP2D. Efficacy evaluation was a secondary objective. TEAEs were assessed per CTCAE v5.0 and tumor response per IMWG 2016 criteria. Results: As of May 2023, 220 pts received ABBV-383 (median age: 68 yr [35–92]; median prior therapy lines: 5 [3‒23]). Median FU was 4.1 mo (0.8–5.2) at 60mg Q4W (n=21), 12.2 mo (1.3–34.4) at 40mg Q3W (n=55), and 24.2 mo (0.6–33.4) at 60mg Q3W (n=61). At 60mg Q4W, with the modified premedication regimen, CRS was reported in 43% of pts (38% G1, 5% G2), and ICANS in 5% of pts (G2). In Q3W cohorts, CRS was reported in 71% (40mg; 45% G1, 25% G2) and 70% (60mg; 51% G1, 18% G2, 2% G3) of pts. The incidence of G3/4 neutropenia, anemia, and thrombocytopenia was 14/24/10% at 60mg Q4W, 31/31/16% at 40mg Q3W, and 34/13/13% at 60mg Q3W. G3/4 infections occurred in 10/24/34% of pts at 60mg Q4W, 40mg and 60mg Q3W, respectively. ORR and ≥VGPR were 65/50% at 60mg Q4W, 64/53% at 40mg Q3W, and 60/52% at 60mg Q3W. Corresponding exposure-response (ER) analyses and correlative analyses further supported RP2D determination (separate abstract submissions). Conclusions: The optimal therapeutic dose of 60mg Q4W ABBV-383 monotherapy was selected on the basis of safety, efficacy, and ER analyses. The extended interval of Q4W, with a shortened CRS monitoring period in cycle 1 and no step-up dosing, will improve convenience and reduce the treatment burden for pts. ABBV-383 at 60mg Q4W will be investigated in the registrational phase 3 trial (NCT06158841) in RRMM. Clinical trial information: NCT03933735 .
Comparative effectiveness of linvoseltamab versus standard-of-care (SOC) treatment (tx) in real-world patients (pts) in the United States (US) with triple-class exposed (TCE) relapsed/refractory multiple myeloma (RRMM).
Kumar, Shaji , Ma, Qiufei , Bonar, Nicolle , Spin, Paul , Harnett, James , Ge, Wenzhen , Jalbert, Jessica J. , Kroog, Glenn S. , Rodriguez-Lorenc, Karen, Weisel, Katja C , Hampp, Christian , Humblet, Olivier , Shokoohi, Mostafa , Sobel, Rachel E. , Jagannath, Sundar

Journal of Clinical Oncology | June 10, 2024 | Volume: 42 | Issue: 16_suppl | Pages: 7561-7561

10.1200/jco.2024.42.16_suppl.7561 Get It

7561 Background: Pts with TCE RRMM have poor outcomes and a high unmet need, with no established SOC tx. LINKER-MM1 (NCT03761108) is a single-arm, Phase 1/2 study investigating linvoseltamab, a B-cell maturation antigen × CD3 bispecific antibody, in pts with RRMM who were previously treated with a proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody, or were triple-class refractory (TCR) to these tx. The aim of this study was to contextualize LINKER-MM1 by comparing outcomes with linvoseltamab vs a real-world (RW) external control arm (ECA). Methods: A RW ECA was derived from 2 US electronic health record databases (COTA, Guardian Research Network) of pts who started a new line of therapy (LOT) after classification as TCE or TCR and met key eligibility criteria for LINKER-MM1. Eligibility was assessed at the initiation of each new LOT, and all eligible LOTs were included in the ECA. Data in Phase 2 pts who received linvoseltamab 200 mg in LINKER-MM1 were included (data cutoff: Sep 8, 2023). Inverse probability of tx weighting (IPTW) was used to reduce imbalances between the RW and LINKER-MM1 cohorts. Key prognostic factors were identified using a systematic review and rank ordered by an international committee of MM experts (Kumar et al., 2023). Outcomes included overall response rate (ORR), progression-free survival (PFS), time to next treatment (TTNT), and overall survival (OS). An independent committee of epidemiology and oncology experts reviewed the comparability of the cohorts and endpoint assessments prior to conducting comparative analyses. Results: Comparative analyses were performed in 105 pts in the linvoseltamab cohort and 101 RW pts (137 LOTs). Following IPTW, the distribution of cytogenetic risk, age, TCR status, Eastern Cooperative Oncology Group Performance Status, and platelet count were balanced between the 2 cohorts (absolute standardized mean difference <0.10). After adjustment, pts receiving linvoseltamab had significantly improved ORR, PFS, TTNT, and OS vs the RW ECA (see table). Conclusions: Linvoseltamab significantly improved outcomes vs RW SOC in the US, highlighting its potential as a highly effective tx in pts with TCE RRMM. [Table: see text]
Navigating High-Risk and Ultrahigh-Risk Multiple Myeloma: Challenges and Emerging Strategies
Kumar, Shaji , Rees, Matthew J. , D’Agostino, Mattia , Leypoldt, Lisa Beatrice , Weisel, Katja C , Gay, Francesca

American Society of Clinical Oncology Educational Book | May 21, 2024 | Volume: 44 | Issue: 3 | Pages: No page available

10.1200/edbk_433520 Get It

Despite significant improvement in the outcomes of patients with newly diagnosed multiple myeloma (NDMM) with novel therapies, there is still an underserved high-risk (HR) population that experiences early disease progression and death. With the median survival crossing 10 years, we defined ultrahigh-risk (uHR)MM as MM leading to death within 24-36 months of diagnosis and HRMM as MM leading to death within 36-60 months. Several features have emerged as markers of uHRMM: the co-occurrence of two or more high-risk cytogenetic abnormalities, extramedullary disease, plasma cell leukemia and a high-risk gene expression profiling signature. The heterogeneous risk definition across trials, the few trials available designed for HR patients, and the small HR subgroups in all-comers trials make it difficult to generate recommendations with high levels of evidence. Nevertheless, regardless of treatment administered, several studies consistently showed that achieving and maintaining measurable residual disease negativity is now considered the main factor able to mitigate the adverse prognosis related to baseline features. For fit patients with HR transplant-eligible (TE) NDMM, quadruplet induction/consolidation treatment with anti-CD38 monoclonal antibodies, immunomodulatory agents, proteasome inhibitors and dexamethasone, and autologous stem-cell transplant and maintenance with, if available, at least a doublet combination could be considered the option of choice. For non-TE NDMM, considering the recent data generated and carefully reviewing those upcoming, quadruplet treatment consisting of anti-CD38 monoclonal antibodies, immunomodulatory agents, proteasome inhibitors, and dexamethasone should also be considered. Future trials integrating BCMA-directed novel generation immunotherapies hold great potential for further advancing the treatment landscape in all NDMM patients with HR disease.
Genomic Classification and Individualized Prognosis in Multiple Myeloma
Maura, Francesco , Rajanna, Arjun Raj , Ziccheddu, Bachisio , Poos, Alexandra M. , Derkach, Andriy , Maclachlan, Kylee , Durante, Michael , Diamond, Benjamin , Papadimitriou, Marios , Davies, Faith E. , Boyle, Eileen M. , Walker, Brian A. , Hultcrantz, Malin , Silva, Ariosto, Hampton, Oliver , Teer, Jamie K. , Siegel, Erin M. , Bolli, Niccolò , Jackson, Graham , Kaiser, Martin , Cook, Gordon , Kazandjian, Dickran , Stein, Caleb, Chesi, Marta , Bergsagel, Leif, Elias, K. , Goldschmidt, Hartmut , Fenk, Roland , Rhee, Fritz Van, Usmani, Saad Z. , Shain, Kenneth H. , Weinhold, Niels , Bergsagel, P. Leif , Bergsagel, P. Leif , Davies, Faith E , Walker, Brian A , Jackson, Graham H , Pawlyn, Charlotte , Cook, Gordon , Kazandjian, Dickran , Chesi, Marta , Mai, Elias K , Goldschmidt, Hartmut , Weisel, Katja C , Fenk, Roland , Raab, Marc S , van Rhee, Frits , Usmani, Saad , Shain, Kenneth H , Weinhold, Niels , Landgren, C Ola , Bolli, Niccolo' , Boyle, Eileen M , Kaiser, Martin F , Maura, Francesco , Durante, Michael , Maclachlan, Kylee , Derkach, Andriy , Diamond, Benjamin T , Pawlyn, Charlotte , Stein, Caleb, Raab, Marc S. , Morgan, Gareth J. , Landgren, Ola

Journal of Clinical Oncology | January 9, 2024 | Volume: 42 | Issue: 11 | Pages: 1229-1240

10.1200/jco.23.01277 Get It

PURPOSE Outcomes for patients with newly diagnosed multiple myeloma (NDMM) are heterogenous, with overall survival (OS) ranging from months to over 10 years. METHODS To decipher and predict the molecular and clinical heterogeneity of NDMM, we assembled a series of 1,933 patients with available clinical, genomic, and therapeutic data. RESULTS Leveraging a comprehensive catalog of genomic drivers, we identified 12 groups, expanding on previous gene expression–based molecular classifications. To build a model predicting individualized risk in NDMM (IRMMa), we integrated clinical, genomic, and treatment variables. To correct for time-dependent variables, including high-dose melphalan followed by autologous stem-cell transplantation (HDM-ASCT), and maintenance therapy, a multi-state model was designed. The IRMMa model accuracy was significantly higher than all comparator prognostic models, with a c-index for OS of 0.726, compared with International Staging System (ISS; 0.61), revised-ISS (0.572), and R2-ISS (0.625). Integral to model accuracy was 20 genomic features, including 1q21 gain/amp, del 1p, TP53 loss, NSD2 translocations, APOBEC mutational signatures, and copy-number signatures (reflecting the complex structural variant chromothripsis). IRMMa accuracy and superiority compared with other prognostic models were validated on 256 patients enrolled in the GMMG-HD6 (ClinicalTrials.gov identifier: NCT02495922 ) clinical trial. Individualized patient risks were significantly affected across the 12 genomic groups by different treatment strategies (ie, treatment variance), which was used to identify patients for whom HDM-ASCT is particularly effective versus patients for whom the impact is limited. CONCLUSION Integrating clinical, demographic, genomic, and therapeutic data, to our knowledge, we have developed the first individualized risk-prediction model enabling personally tailored therapeutic decisions for patients with NDMM.
Pharmacokinetics and Immunogenicity of Abbv-383, a B-Cell Maturation Antigen (BCMA) × CD3 Bispecific T-Cell-Redirecting Antibody, in Patients with Relapsed/Refractory Multiple Myeloma (RRMM)
Polepally, Akshanth R. , Boehm, Nils, Kumar, Shaji , Voorhees, Peter M. , Bueno, Orlando F. , Talati, Chetasi, Menon, Rajeev , Biesdorf, Carla , Uddin, Muhammad Erfan , Ross, Jeremy A. , D’Souza, Anita , Weisel, Katja C , Talati, Chetasi

Blood | December 2, 2023 | Volume: 142 | Issue: Supplement 1 | Pages: 6722-6722

10.1182/blood-2023-180127 Get It

Introduction ABBV-383 is a fully human, silenced Fc region IgG4 monoclonal, BCMA × CD3 T-cell-engaging bispecific antibody with 2 BCMA-binding domains and a low-affinity CD3-binding domain. ABBV-383 has shown promising activity following intravenous (IV) infusion every three weeks (Q3W) as monotherapy in patients (pts) with RRMM in an ongoing phase 1 study (D'Souza A, et al. J Clin Oncol. 2022 Nov 1;40(31):3576-3586; Voorhees et al. Blood 2022;140[suppl 1]:4401). Herein, preliminary pharmacokinetic (PK) and immunogenicity results from Q3W regimens of this study and impact of soluble BCMA (sBCMA) on ABBV-383 PK are reported. Methods In the phase 1 study (NCT03933735), adult pts with RRMM, who were previously exposed to ≥3 prior multiple myeloma agents including ≥1 proteasome inhibitor, immunomodulatory drug, and anti-CD38 monoclonal antibody, received Q3W IV infusion at doses 0.025 - 120 mg in escalation (ESC) phase, and at 20 mg, 40 mg, and 60 mg in expansion (EXP) phase. Serial blood samples for PK characterization were collected in cycles 1, 3, and 6 along with sparse/periodic samples throughout the study. Blood samples were also collected throughout the study to detect anti-drug antibodies (ADAs) for immunogenicity characterization and to determine sBCMA concentrations. Appropriate validated assays were used to determine ‘total’ (unbound and bound to sBCMA) and ‘free’ (unbound and partially bound to sBCMA) ABBV-383 serum concentrations, to detect/determine ADAs/titers, and to determine total sBCMA concentrations. ‘Total’ and ‘free’ ABBV-383 serum concentrations from cycles 1, 3, and 6 were used to calculate individual PK parameters (peak concentration [C max], trough concentration [C trough], area under the concentration-time curve [AUC], terminal phase elimination half-life [t 1/2], clearance [CL], and steady state volume of distribution [V ss]) using non-compartmental analysis in Phoenix WinNonlin Version 8.2. Immunogenicity was summarized using ADA/titer data. Impact of baseline/pre-dose sBCMA concentrations on ‘total’ and ‘free’ ABBV-383 PK parameters from cycles 1, 3, and 6 was explored. Results ‘Total’ and ‘free’ ABBV-383 intensive PK data (cycles 1, 3, and 6) were available from 169 and 157 pts, respectively, representing Q3W regimens in ESC and EXP cohorts and ADA data were available from 186 evaluable subjects. Preliminary PK results suggest that ‘total’ and ‘free’ ABBV-383 exhibited approximately dose-proportional PK between 5.4-120 mg Q3W. Estimated t 1/2 for ‘total’ and ‘free’ ABBV-383 ranged between 11-12 days and 8-11 days, respectively, with steady state achieved by cycle 4 in Q3W EXP cohorts. Estimated CL and V ss were consistent with those of a typical IgG4 antibody in humans. Across EXP Q3W regimens, accumulation (cycle 3 vs. cycle 1) was 30%-60% in C max and 60%-177% in C trough for ‘free’ and ‘total’ ABBV-383. ABBV-383 exposures (AUC tau and C trough) of ‘total’ ABBV-383 were 28-74% higher than those representing ‘free’ ABBV-383 among the EXP Q3W regimens with no/minimal observed differences in C max (≤21%). Higher sBCMA levels prior to treatment appeared to reduce ‘free’ ABBV-383 PK exposures with pronounced reduction at lower doses (e.g., 20 mg) and in cycle 1, however the effect diminished in later cycles (cycles 3 and 5). Preliminary assessment of immunogenicity indicated an ADA incidence of 3.8% (7/186) with low titers ranging between 11.7 and 187 titer units and no impact on PK. Conclusions ABBV-383 exhibited a PK profile with relatively long half-life and low incidence of immunogenicity. Overall, sBCMA impacted (reduced) the ‘free’ ABBV-383 (pharmacologically active component) PK exposures only, with pronounced effect at lower doses and the effect is consistent with understanding of treatment dependent sBCMA dynamics over time. Determination of both ‘total’ and ‘free’ ABBV-383 serum concentrations allowed to demonstrate such underlying impact of sBCMA on PK.
Updated Safety and Efficacy Results of Abbv-383, a BCMA x CD3 Bispecific T-Cell Redirecting Antibody, in a First-in-Human Phase 1 Study in Patients with Relapsed/Refractory Multiple Myeloma
Vij, Ravi , Kumar, Shaji , McKay, J., Voorhees, Peter M. , Korde, Neha , Bueno, Orlando F. , Feng, Zhongling, Rosenberg, Tanya S, Pothacamury, Rajvineeth Kumar, Polepally, Akshanth R. , Ahsan, Aarif, Talati, Chetasi, Valdes, Cesar Rodriguez , D’Souza, Anita , Chung, Alfred , Tuchman, Sascha Alexander , Weisel, Katja C , Teipel, Raphael , Lee, Shane , Jin, Ziyi , Ross, Jeremy A. , Talati, Chetasi

Blood | December 1, 2023 | Volume: 142 | Issue: Supplement 1 | Pages: 3378-3378

10.1182/blood-2023-182388 Get It

Background ABBV-383 is an off-the-shelf, fully human B-cell maturation antigen (BMCA) X CD3 bispecific antibody with bivalent BCMA domain and low CD3 affinity that targets both BCMA-expressing multiple myeloma (MM) cells and CD3-expressing T cells. ABBV-383 has shown promising activity in an ongoing phase 1 study in patients (pts) with relapsed/refractory (RR) MM ( Voorhees et al. ASH 2022; Weisel et al. EHA 2023). Here, we report the safety and efficacy results from the ABBV-383 IV Q3W at 20 mg, 40 mg and 60 mg dose levels. Methods The phase 1 dose escalation (ESC) and expansion (EXP) study (NCT03933735) of ABBV-383 enrolled pts with RRMM with ≥3 prior lines of therapy (LOT), including a PI, IMiD, and an anti-CD38 mAb with no prior BCMA exposure. After exploring 14 dose levels in dose ESC, 3 dose levels were further explored in dose EXP including ABBV-383 Q3W IV 20 mg, 40 mg, and 60 mg, until disease progression/unacceptable toxicity. The primary objectives were to determine safety/tolerability, PK/PD, and RP2D. The secondary objective was to evaluate clinical activity. Responses were investigator assessed per IMWG 2016 criteria and adverse events (AEs) by CTCAE v5.0. Results As of 17May2023, 220 pts were treated with ABBV-383, 73 pts in the dose ESC and 147 in the dose EXP with 32 pts at 20 mg, 55 pts at 40 mg, and 61 pts at 60 mg Q3W. Median duration of follow up was 7.1 (0.8-36.9), 12.2 (1.3-34.4) and 24.2 (0.6-33.4) months (mo) in the 20 mg, 40 mg and 60 mg dose levels with 25%, 36% and 21% pts continuing treatment (tx), respectively. Median age for all pts was 68 yrs (range, 35-92 yrs), Median prior LOT was 5 (range, 3-23), and 80% were triple-class refractory. Baseline characteristics are summarized in Table 1 by dose level. Treatment-emergent (TE) AEs were reported in 97% (78% ≥G3) of pts at 20 mg, 100% (84% ≥G3) of pts at 40 mg, and 100% (82% ≥G3) of pts at 60 mg. CRS, the most common TEAE, occurred in 50% (34% G1/13% G2/3% G3) of pts at 20 mg, 71%(45% G1/25% G2/0% ≥G3) of pts at 40 mg, and 70%(51% G1/18% G2/2% G3) of pts at 60mg. At the 3 dose levels, CRS occurring after the first dose had median time to onset of 1 day (range, 1-2) and median duration was 2 days (range, 1-10). ICANS occurred in 3% (3% G1/0% ≥G2) of pts at 20 mg, 5% (2 % G1/4% G2/0% ≥G3) of pts at 40 mg, and 5% (3% G2/2% G3) of pts at 60 mg. No G4/5 CRS or ICANS occurred. Infections occurred in 56% (25% ≥G3) of pts at 20 mg, 71% (26% ≥G3) of pts at 40 mg, and 57% (34% ≥G3) of pts at 60 mg; most frequently (≥10%) reported were upper respiratory tract infections (15%, G3/4 1%), pneumonia (14%, G3/4 12%), urinary tract infections (12%, G3/4 3%), and COVID-19 (11%, G3/4 1%). At 20 mg, 40 mg, and 60 mg, the incidence of neutropenia was 41% (25% ≥G3), 42% (31% ≥G3), and 43% (34% ≥G3); anemia 50% (25% ≥G3), 55% (31% ≥G3), and 38% (13% ≥G3); thrombocytopenia 44% (28% ≥G3), 36% (16% ≥G3) and 26% (13% ≥G3), respectively. The tx discontinuation due to AEs was 6%, 11%, 10% in 20 mg, 40 mg and 60 mg, respectively, with no single PT reported in &gt;2 pts. Clinical responses are shown in Figure 1. The median time to ≥VGPR was 0.7mo (0.7-5.8) at 20 mg, 1.0mo (0.7-10.4) at 40 mg, and 1.4 mo (0.7-7.8) at 60 mg. The median DOR was 9.7 mo (3.5-not reached (NR)) at 20 mg, and NR at 40 mg and 60 mg. The Kaplan-Meier (KM) estimates for DOR at 12 mo was 42% at 20 mg, 70% at 40 mg, 66% at 60 mg. The mPFS was 3.8 mo (2.4-7.9) at 20mg, 13.7mo (5.0-NR) at 40 mg, and 11.2 mo (4.8-NR) at 60 mg. The KM estimates for PFS at 12 mo was 19% at 20 mg, 51% at 40 mg, 49% at 60 mg. The median OS was 21.6 mo (7.9-NR) at 20 mg, and NR at 40 mg and 60 mg. ABBV-383 at 20 mg, 40 mg, and 60 mg led to rapid and transient production of key proinflammatory cytokines (IL-6, IL8, IFN-γ, and TNF-α), and reduction of soluble BCMA levels over time that were associated with disease response. ABBV-383 also promoted T-cell activation and proliferation with upregulation of CD69 and KI67 markers on peripheral CD4 and CD8 T cells in evaluable pts. Conclusions ABBV-383 showed a manageable safety profile at dosages of 20 mg, 40 mg, and 60 mg IV Q3W, with low incidence of TEAEs leading to discontinuation. Also, extended Q3W dosing interval with no step-up dosing schedule of ABBV-383 may provide enhanced convenience. However, 20 mg yielded numerically lower responses when compared to 40 mg and 60 mg. At 40 mg and 60 mg, ABBV-383 monotherapy yielded deep and durable responses with mPFS of 13.7 mo and 11.2 mo, and 12-month DOR of 70% and 66% (mDOR NR in pts with ≥CR), respectively. These results in heavily pretreated RRMM pts support further clinical evaluation.
P16 HEALTH-RELATED QUALITY OF LIFE FOR FRAIL TRANSPLANT-INELIGIBLE PATIENTS WITH NEWLY DIAGNOSED MULTIPLE MYELOMA TREATED WITH DARATUMUMAB, LENALIDOMIDE AND DEXAMETHASONE: SUBGROUP ANALYSIS OF MAIA TRIAL
Plesner, Torben , Kumar, Shaji , Hulin, Cyrille , Delforge, Michel, Karlin, Lionel, Arnulf, Bertrand , Pei, Huiling , Kaila, S., Matt, K., Gries, Katharine S. , Carson, Robin, Borgsten, F., Facon, Thierry T.F. , Usmani, Saad Z. , Bahlis, Nizar Jacques , Orlowski, Robert Z. , Nahi, Hareth , Mollee, Peter , Ramasamy, Karthik , Roussel, Murielle , Jaccard, Arnaud , Karlin, Lionel , Chari, Ajai , Gupta, Neeraj , Matt, K., Weisel, Katja C , Perrot, Aurore

HemaSphere | November 16, 2023 | Volume: 7 | Issue: S2 | Pages: 18-19

10.1097/01.hs9.0000936192.21618.f2 Get It

P09 DARATUMUMAB PLUS LENALIDOMIDE AND DEXAMETHASONE (D-RD) VERSUS LENALIDOMIDE AND DEXAMETHASONE (RD) ALONE IN TRANSPLANT-INELIGIBLE PATIENTS WITH NEWLY DIAGNOSED MULTIPLE MYELOMA (NDMM): UPDATED ANALYSIS OF THE PHASE 3 MAIA STUDY
Kumar, Shaji , Facon, T., Plesner, Torben , Hulin, Cyrille , Goldschmidt, Hartmut , Venner, Christopher P. , Tiab, Mourad, Macro, Margaret , Leleu, Xavier , Pei, Huiling , Krevvata, Maria, Carson, Robin, Borgsten, F., Weisel, Katja C , Moreau, Philippe , Bahlis, Nizar Jacques , Orlowski, Robert Z. , Basu, Supratik , Nahi, Hareth , Quach, Hang , O’Dwyer, Michael , Perrot, Aurore , Raje, Noopur , Frenzel, Laurent , Usmani, Saad Z.

HemaSphere | November 16, 2023 | Volume: 7 | Issue: S2 | Pages: 14-15

10.1097/01.hs9.0000936164.84357.ed Get It