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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Tuesday, January 10, 2023
Suzanne Trudel, MD, of Princess Margaret Cancer Centre, University of Toronto, Ontario, Canada, and colleagues added a tocilizumab pretreatment arm to an existing phase I study of cevostamab—a FcRH5 and CD3 T-cell–dependent bispecific monoclonal antibody—in patients with relapsed or refractory multiple myeloma. The results of this study, which were presented during the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 567), determined that such pretreatment may reduce the risk of developing cytokine-release syndrome, with no apparent impact on antitumor activity.
The investigators focused on 72 patients with relapsed or refractory multiple myeloma for which no established therapy was appropriate, available, or tolerable. Participants in both the tocilizumab pretreatment arm (n = 28) and the non-pretreatment arm (n = 44) received intravenous cevostamab during a 21-day cycle.
In the pretreatment arm, 78.6% of patients had triple-class–refractory disease, and 42.9% had penta-refractory disease; 86.4% and 72.7% had triple-class– and penta-refractory disease in the non-pretreatment arm, respectively. Those in the non-pretreatment arm had a longer median time on study than did those in the pretreatment arm (13.1 vs. 4.7 months). The overall response rates in the pretreatment and non-pretreatment arms were 50% and 37.2%, respectively, with very good partial response or better rates of 26.9% and 25.6%.
Additionally, patients who did not undergo pretreatment had a significantly higher rate of cytokine-release syndrome than the pretreatment group (90.9% vs. 35.7%). Of note, rates of other adverse events were similar between each arm except for neutropenia; grade 3 or 4 neutropenia affected 64.3% of patients in the pretreatment arm and 38.6% in the comparator arm. However, neutropenia events were reported to be reversible and manageable in both arms, and no events led to cevostamab discontinuation.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2022 ASH Annual Meeting and Exposition
