Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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linvoseltamab for Myeloma
linvoseltamab for Myeloma is yet another possible therapy for relapsed/refractory MM patients. Prospective MM patients must remember, however, that this new therapy comes with serious risks.
I am a long-term myeloma survivor. I know full-well why MM patients take greater risks as their therapy options become fewer and fewer.
While BiTE therapies:
- teclistamab-cqyv (Tecvayli)
- talquetamab-tgvs (Talvey) and
- elranatamab-bcmm (Elrexfio)
are therapy options for RR/MM patients, they come with serious side effect- consider those therapies that may not be offered by your oncologist.
What are the possible side effects of BiTE agents for myeloma?
- Cytokine release syndrome (CRS): This is a systemic inflammatory response that can occur when activated immune cells release large amounts of cytokines into the bloodstream. Symptoms can range from mild flu-like symptoms to more severe reactions such as high fever, low blood pressure, and organ dysfunction.
- Neurotoxicity: Some patients may experience neurological side effects such as confusion, delirium, seizures, or headaches. Neurotoxicity can be mild or severe and may require treatment or discontinuation of the BiTE therapy.
- Hematologic toxicity: BiTE therapy can sometimes lead to decreased levels of certain blood cells, such as red blood cells (anemia), white blood cells (neutropenia), and platelets (thrombocytopenia). This can increase the risk of infections, bleeding, and fatigue.
- Infusion reactions: Some patients may experience infusion-related reactions during or shortly after receiving BiTE therapy. Symptoms can include fever, chills, nausea, vomiting, rash, and shortness of breath.
- Infections: Treatment with BiTE agents may weaken the immune system, increasing the risk of infections. Patients receiving BiTE therapy should be closely monitored for signs of infection and may require prophylactic antibiotics or antiviral medications.
- Liver toxicity: Elevated liver enzymes and liver function abnormalities have been reported in some patients receiving BiTE therapy. Regular monitoring of liver function tests is typically recommended during treatment.
- Other potential side effects: Other less common side effects of BiTE therapy may include fatigue, diarrhea, peripheral neuropathy, and cardiac toxicity.
Consider complementary and/or integrative therapies. For example, curcumin has been shown to enhance the efficacy of velcade and protect normal cells.
Are you a myeloma survivor who has relapsed after 2,3,4 rounds of therapy? If you’d like to learn more about evidence-based non-conventional myeloma therapies email me at David.PeopleBeatingCancer@gmail.com
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
linvoseltamab for myeloma is a Bispecific T-Cell Engager (BiTE) Antibodies.
New BiTE Agents Provide Effective Options for Treatment of Relapsed/Refractory Multiple Myeloma
“Since October 2022, 7 new agents have been approved by the FDA based on the treatment paradigm of bispecific T-cell engagement…
Of the 7 new approvals in the past year, 3 of the agents have been approved for relapsed/refractory (R/R) multiple myeloma (MM). These agents are
- teclistamab-cqyv (Tecvayli; Janssen Biotech), which was approved on October 25, 2022;
- talquetamab-tgvs (Talvey; Janssen Biotech), which was approved August 9, 2023; and
- elranatamab-bcmm (Elrexfio; Pfizer), which was approved August 14, 2023.
New Agent Shows Early Promise in Triple-Class Refractory Multiple Myeloma
“The bispecific antibody linvoseltamab (Regeneron) can induce deep and durable responses in patients with relapsed or refractory multiple myeloma, according to results from the phase 1/2 LINKER-MM1 trial…
Overall, linvoseltamab demonstrated “high efficacy in patients with late-stage” disease, including those with high-risk features…
However, five patients died from treatment related infections and one from treatment related renal failure, Jagannath reported…
- Proteasome inhibitors,
- immunomodulatory drugs,
- and anti-CD38 antibodies
are the current pillars of multiple myeloma treatment…
Their increasing use in earlier lines of treatment has led to resistance, creating a challenge for patients who become refractory to all three classes of drugs…
Bispecific antibodies, such as linvoseltamab, that target B-cell maturation antigen on the surface of multiple myeloma cells and CD3 receptors on the surface of T cells…
A total of 117 patients in the single arm LINKER-MM1 trial were infused with:
- 5 mg of linvoseltamab on day 1,
- 25 mg on day 8, then
- 200 mg once a week to week 14,
- followed by 200 mg every 2 weeks to week 23.
Patients moved on to monthly dosing at that point if they had at least a very good partial response. Median exposure to linvoseltamab was 47.5 weeks…
Eighty-two percent of participants were at least triple-class refractory. More than a quarter were aged ≥ 75 years, and 17.1% were Black individuals, reflecting multiple myeloma demographics.
The overall response rate in the 17.9% of subjects with stage III disease was 62%, with complete responses in 43%; among the 16.2% with extramedullary plasmacytomas, overall response rate was 53% with complete responses in 26%…
Among bispecific antibodies already on the US market for relapsed/refractory multiple myeloma, teclistamab and elranatamab had overall response rates of 63% and 61%, respectively, in similar phase 2 testing..
Davies emphasized additional potential advantages for linvoseltamab. While step-up dosing of other bispecifics requires up to 48 hours in the hospital due largely to the risk of cytokine release syndrome (CRS), step-up dosing of linvoseltamab requires just 24 hours because CRS with the agent is mostly grade 1/2 and has a median onset of 11 hours…
Almost three quarters of subjects developed infections, which were grade 3/4 in 34%. Their frequency and severity decreased after 6 months coincident with monthly dosing.
Almost half of patients developed CRS but there was only one grade 3 case and no grade 4/5s. CRS occurred mostly during step-up dosing, and just over half of cases required supportive measures. There were nine cases of immune effector cell-associated neurotoxicity syndrome, all concurrent with CRS and infusion-related reactions…”
1. Diagnosis of plasma cell leukemia, primary systemic light-chain amyloidosis, (excluding myeloma-associated amyloidosis), Waldenström macroglobulinemia (lymphoplasmacytic lymphoma), or POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) 2. Patients with known MM brain lesions or meningeal involvement -Cardiac ejection fraction <40% by echocardiogram or multi-gated acquisition scan (MUGA) 3. Prior treatment with BCMA-directed immunotherapies, including BCMA bispecific antibodies and BiTEs. Note: BCMA antibody-drug conjugates are not excludedand BCMA-directed CAR-T treatment is not excluded in Phase 2 Cohort 3.
4. History of allogeneic stem cell transplantation at any time, or autologous stem cell transplantation within 12 weeks of the start of study treatment
Note 1: Other protocol defined inclusion / exclusion criteria apply Note 2: US enrollment completed