- |||||||||| Tecvayli (teclistamab) / Genmab, J&J
Drug Interaction Potential As a Result of Cytokine Release Syndrome Using a Physiologically Based Pharmacokinetic Model: Case Study of Teclistamab (ENMCC - Hall D) - Nov 4, 2022 - Abstract #ASH2022ASH_4605; Drug-drug interaction (DDI) toward different CYP substrates (caffeine [CYP1A2], s-warfarin [CYP2C9], omeprazole [CYP2C19], midazolam and cyclosporine [CYP3A4 and CYP3A5], and simvastatin [CYP3A4]) were evaluated where substrates were administered as a single dose when the minimum (or the maximum for CYP1A2) enzymatic activity was reached...Then, prospective simulations were performed using observed IL-6 data following teclistamab administered at RP2D without or prior to tocilizumab administration in MajesTEC-1 as of a March 16, 2022, cut-off... PBPK modeling and simulation results suggested DDI from IL-6 effect on CYP450 activities to have little clinical significance with minimal or moderate impact on CYP substrates up to 7 days after teclistamab first treatment dose in cycle 1 or during a cytokine release syndrome event.
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ISB 2001, a First-in-Class Trispecific BCMA and CD38 T Cell Engager Designed to Overcome Mechanisms of Escape from Treatments for Multiple Myeloma By Targeting Two Antigens (New Orleans Theater C (Ernest N. Morial Convention Center)) - Nov 4, 2022 - Abstract #ASH2022ASH_1415; However, despite exceptional overall response rates observed using CAR T cell therapies or bispecific antibodies, durable responses beyond 2 years are still limited (PFS below 40% for treatment with idecabtagene vicleucel1 or teclistamab2)...This low expression of targets in the MM population has been observed after treatment with CD38-targeted daratumumab4, and BCMA specific CAR T cells5...ISB 2001 was only modestly affected by soluble BCMA or APRIL when compared to EM801, demonstrating killing at 3 pM (EC50) in the presence of these soluble factors...Seckinger, A. et al. Cancer Cell 31, 396–410 (2017).
- |||||||||| elranatamab (PF-06863135) / Pfizer, Tecvayli (teclistamab) / Genmab, J&J
Role of TNFRSF17 and GPRC5D Structural and Point Mutations in Resistance to Targeted Immunotherapies in Multiple Myeloma (MM) (ENMCC - R06-R09) - Nov 4, 2022 - Abstract #ASH2022ASH_1403; Importantly, we also identified a monoallelic loss of TNFRSF17 (del16p) coupled with BCMA extracellular domain point mutation [p.(R27P)] that confers resistance to two BCMAxCD3 TCEs in MM. Therefore, in addition to structural alterations (biallelic loss of TNFRSF17 or GPRC5D), antigen escape resulting from non-truncating missense point mutations in BCMA extracellular domain also mediate resistance to targeted-immunotherapies.
- |||||||||| Tecvayli (teclistamab) / Genmab, J&J
Journal: Teclistamab Approved for Myeloma. (Pubmed Central) - Nov 3, 2022 The FDA has approved the bispecific T-cell engager teclistamab for patients with relapsed or refractory multiple myeloma. In the clinical trial that led to its approval, patients had an overall response rate of 63% and a median duration of response of 18.4 months.
- |||||||||| Abecma (idecabtagene vicleucel) / BMS, 2seventy bio, Tecvayli (teclistamab) / Genmab, J&J, Blenrep (belantamab mafodotin) / GSK
Now that we have BCMA directed CAR-Ts (ide-cel, cilta cel), ADC (belantamab), & bispecific (teclistamab) how do we approach refractory myeloma?👇 For triple class refractory, its either alkylator based or BCMA directed therapy. For penta class refractory, some options promising. (Twitter) - Oct 28, 2022
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