Elranatamab + Carfilzomib: Results in Relapsed/Refractory Myeloma

Hi, I'm Michael Thomason. I'm from the University of Iowa, Department of Internal Medicine, and I'm here talking about abstract number 1024, which is a study in relapsed and refractory multiple myeloma treated with a bispecific antibody called L-Renatumab and carfilzomib, a second generation proteasome inhibitor. It was a small study, but we have a lot of experience with L-Renatumab, so this fits into sort of the constellation of knowledge we have about it. The exciting thing about it is that we had 12 patients and 100% of them responded. So the combination is very immunosuppressive, so patients and physicians have to be aware of the fact that virus reactivation, CMV reactivation, replacement with IVIG for, that's intravenous immunoglobulin to make sure patients aren't very immunosuppressed, they need to be kept an eye on. The patients have an improvement of their quality of life and have done extremely well so far, so we're very excited to keep the study open and to continue enrolling. So L-Renatumab is the second of the bispecific antibodies targeted towards BCMA or B-cell maturation antigen, so I think most people in myeloma, patients and families even, are aware of BCMA. There are CAR T cells targeted for BCMA and two different bispecific antibodies. The idea of the bispecific antibody is one side binds the BCMA on the tumor cell and the other side binds a T cell, your normal T cell, kind of brings them together so the T cell can destroy the myeloma cell. So carfilzomib is a second generation, most people know Velcade was one of the breakthrough agents as a proteasome inhibitor in multiple myelomas, very efficacious. And carfilzomib is a second generation, a little bit more efficacious, so it's a good agent to use for patients who may have seen Velcade up front. So it's a repeat of a proteasome inhibitor in combination with the immunotherapy and it's very safe and effective. I think that the field has looked at the BCMA as a target, so I think there's no more question. BCMA is an outstanding target, it marks the tumor cells. We're very fortunate, sounds a little unusual to say, for cancer, so I don't mean to imply anything about the patients or families suffering from this, but myeloma, a field, is very fortunate to have something like BCMA as a pretty specific marker of the cancer. So it's very highly efficacious binding to the tumor cell specifically and bringing this idea that was a brilliant idea of bringing the T cells, your own body's T cells, to come in and attack the tumor cells, turns out it's also myeloma happens to be primed for that to work. The main thing I'd like to get across is when we're in the laboratory and researching, writing grants and trying to get resources for our work as scientists and physicians, we like to say from decades ago that myeloma is an incurable disease and I just don't think that's true anymore. We have a lot of patients who are living very long and happy lives. All of us have pictures of patients on vacations that we wish we could take. So I think the idea that this myeloma is a death sentence is very old fashioned now. It's a very annoying diagnosis. You need treatment, but it's not necessarily going to end your life if you have that. So I think there's a tremendous amount of hope and we're very cautious about the use of the word cure, but I think that is what we're looking at in the next five years.