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ASCO 2023: TRIMM-2 Update Supports Steroid-Sparing Regimen for Resistant Myeloma

By: Julia Fiederlein Cipriano
Posted: Monday, June 5, 2023

According to Bhagirathbhai R. Dholaria, MBBS, of Vanderbilt University Medical Center, Nashville, and colleagues, the T-cell–redirecting bispecific antibody talquetamab in combination with the anti-CD38 monoclonal antibody daratumumab demonstrated deep and durable responses in heavily pretreated patients with relapsed or refractory multiple myeloma. The updated results from the TRIMM-2 trial, which were presented during the 2023 American Society for Clinical Oncology (ASCO) Annual Meeting (Abstract 8003), did not reveal any new safety signals.

A total of 65 patients received 1,800 mg of subcutaneous daratumumab in combination with either a recommended phase II dose of 0.4 mg/kg weekly or 0.8 mg/kg biweekly subcutaneous talquetamab with step-up dosing. In this population, prior treatments included anti-CD38 (88%), anti–B-cell maturation antigen (BCMA; 54%), bispecific antibody (25%), and anti-BCMA chimeric antigen receptor T-cell (17%) therapy. Follow-up data were provided for a median of 11.5 months.

All patients experienced at least one adverse event; cytokine-release syndrome (78%), dysgeusia (75%), dry mouth (55%), anemia (52%), fatigue (45%), and skin exfoliation (45%) were reported most frequently. Infections and neutropenia occurred in 63% and 38% of patients, respectively. A total of 85% of patients demonstrated post-baseline immunoglobulin G levels of less than 500 mg/dL; of this population, 32% received intravenous immunoglobulin. Immune effector cell–associated neurotoxicity syndrome was reported in 5% of patients.

Across the recommended phase II doses, the objective response rate was 78% in the overall population and 100% in those who had not undergone prior anti-CD38 therapy. In patients who were exposed or refractory to prior treatment, the objective response rates were 75% and 76% with anti-CD38 therapy, 74% and 64% with anti-BCMA therapy, and 75% and 75% with bispecific antibody therapy, respectively. At 12 months, 86% of responders continued to respond. The median duration of progression-free survival was 19.4 months; the 12-month progression-free and overall survival rates were 76% and 93%, respectively.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.


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