Updated Linvoseltamab Data Showcase Continued Deepening of Responses in Patients with Heavily Pre-Treated Multiple Myeloma

Rhea-AI Summary

Regeneron Pharmaceuticals announced 14-month follow-up data from the LINKER-MM1 trial on linvoseltamab for relapsed/refractory multiple myeloma. The trial showed a 71% overall response rate (ORR) and 50% complete response (CR) or better. Median duration of response (DoR) was 29 months, and median overall survival (OS) was 31 months. Safety data were consistent with previous results, with cytokine release syndrome (CRS) in 46% of patients as the most common adverse event. Linvoseltamab showed better outcomes compared to real-world standard care. The U.S. FDA has given it Fast Track Designation and Priority Review, with a decision expected by August 22, 2024. The drug is also under review by the European Medicines Association and is in a Phase 3 confirmatory trial.

Positive

• 71% overall response rate (ORR) achieved.
• 50% of patients achieved a complete response (CR) or better.
• Median duration of response (DoR) was 29 months.
• Median overall survival (OS) was 31 months.
• 70% estimated probability of being progression-free at 12 months.
• Linvoseltamab outperformed real-world standard-of-care treatment.
• Fast Track Designation and Priority Review by the U.S. FDA.
• Under review by European Medicines Association.
• Phase 3 confirmatory trial (LINKER-MM3) is ongoing.

Negative

• 46% of patients experienced cytokine release syndrome (CRS).
• 74% of patients had infections, with 36% being Grade 3 or 4.
• 42% of patients experienced Grade 3 or 4 neutropenia.
• 31% of patients experienced Grade 3 or 4 anemia.
• Six deaths were considered due to treatment-emergent adverse events (TEAEs).

Insights

Oncology Doctor

The data from the 14-month median follow-up of the Phase 1/2 LINKER-MM1 trial is noteworthy for its demonstration of durable and deep responses in patients with heavily pre-treated multiple myeloma (MM). Achieving a 50% complete response or better, along with a 71% overall response rate, indicates a significant therapeutic effect, especially considering the refractory nature of the patient population. The detailed response rates (such as the 63% achieving a very good partial response or better) further reinforce linvoseltamab's efficacy. Moreover, the median duration of response of 29 months is particularly compelling, suggesting sustained benefits. Importantly, these results also highlight high response rates in prespecified subgroups, including older adults and those with high cytogenetic risk, which are typically difficult-to-treat populations. However, the treatment also comes with notable side effects, such as cytokine release syndrome and significant rates of infection. Investors should balance these promising efficacy data with the potential safety risks.

Medical Research Analyst

The comparison of linvoseltamab to real-world standard-of-care (SOC) treatment in the retrospective study offers valuable insights. The stark differences in outcomes – with linvoseltamab showing a substantially higher objective response rate (70% vs. 32%) and markedly longer progression-free survival (20 months vs. 3 months) – suggest that linvoseltamab could represent a significant advancement in treatment for relapsed/refractory multiple myeloma. These data points not only bolster the therapeutic profile of linvoseltamab but also set high expectations for its market potential upon approval. However, investors should be cautious, as retrospective studies can have inherent biases and the results need to be confirmed in ongoing Phase 3 trials. Additionally, the adverse events profile, including the incidence of cytokine release syndrome and infections, needs thorough consideration when assessing the overall benefit-risk ratio.

Financial Analyst

From a financial perspective, the promising data from the LINKER-MM1 trial could have significant implications for Regeneron Pharmaceuticals. With linvoseltamab receiving Fast Track Designation and acceptance for Priority Review by the FDA, the anticipation of approval could drive positive market sentiment. The potential market for a highly effective multiple myeloma therapy is substantial, especially given the high unmet need in this heavily pre-treated population. The observed median overall survival of 31 months is a strong indicator of the drug's potential impact, which could translate into considerable revenue streams post-approval. However, the financial community should remain vigilant about the safety data and the costs associated with managing adverse events, which might affect the drug's adoption and profitability. It’s important to monitor upcoming regulatory decisions and the results from the Phase 3 LINKER-MM3 trial for further validation.

At 14-months median follow-up in the pivotal trial, 50% of patients achieved a complete response or better and a 71% overall response rate, as presented in an EHA oral presentation and simultaneously published in the Journal of Clinical Oncology

Also presented at EHA, a retrospective study of patient outcomes that compared investigational linvoseltamab to real-world standard-of-care treatment in clinical practice

TARRYTOWN, N.Y., June 16, 2024 (GLOBE NEWSWIRE) -- Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) today announced that 14-month median follow-up data from the pivotal Phase 1/2 LINKER-MM1 trial of linvoseltamab in patients with relapsed/refractory (R/R) multiple myeloma (MM) were shared during an oral presentation at the European Hematology Association (EHA) Congress 2024 and published in the Journal of Clinical Oncology. These longer-term results show a deepening of responses following the 11-month median follow-up data presented at the American Association for Cancer Research Annual Meeting in April. Linvoseltamab is an investigational bispecific antibody designed to bridge B-cell maturation antigen (BCMA) on multiple myeloma cells with CD3-expressing T cells to facilitate T-cell activation and cancer-cell killing.

“Previous results from LINKER-MM1 have demonstrated that linvoseltamab has compelling efficacy characterized by deep and durable responses. With 14-months of median follow-up, 50% of patients achieved a complete response or better, despite their cancer being refractory to or relapsing on standard therapies,” said Suzanne Lentzsch, MD, PhD, Director of the Multiple Myeloma and Amyloidosis Program at Columbia University. “Additionally, a study using US-based electronic health record data to indirectly compare linvoseltamab to real-world standard-of-care treatment also support the overall body of evidence for this investigational medicine in heavily pretreated multiple myeloma. Collectively, these presentations underscore the exciting potential of linvoseltamab as we await decisions from regulatory authorities.”

The 14-month median follow-up LINKER-MM1 data for linvoseltamab among patients treated at the 200 mg dose (N=117) reinforce the durability and increasing depth of response shown in previous data cuts. Per the presentation and publication, results showed:

• 71% objective response rate (ORR), with 50% of patients achieving a complete response (CR) or better and 63% achieving a very good partial response (VGPR) or better, as determined by an independent review committee.
• Median duration of response (DoR) of 29 months for all responders, while median DoR was not reached for those who achieved a CR or better. In analyses that were not pre-specified, there was an 81% and 95% estimated probability of maintaining a response at 12 months after achieving a partial response or better among all patients and those who achieved a CR or better, respectively.
• Median progression-free survival (PFS) was not reached. There was a 70% estimated probability of being progression free at 12 months among all patients; the estimated probability was 96% among those who achieved a CR or better, per an analysis that was not pre-specified.
• Median overall survival (OS) of 31 months for all patients (95% CI: 22 months to NE). In analyses that were not pre-specified, the median OS was not reached for patients who achieved a CR or better, and there was a 75% and 100% estimated probability of survival at 12 months among all patients and those who achieved a CR or better, respectively.
• High rates of CRs or better in prespecified subgroups, including 55% (17 of 31 patients) among those aged 75 years or older, 48% (22 of 46 patients) among those with high cytogenetic risk, 45% (9 of 20 patients) among Black or African American patients, and 28% (10 of 36 patients) among those with plasmacytomas (including extramedullary and paramedullary).
  

Safety data at the 14-month median follow-up was generally consistent with those at the 11-month median follow-up. Cytokine release syndrome (CRS) was the most commonly occurring treatment-emergent adverse event (TEAE) and was observed in 46% of patients; 35% were Grade 1, 10% were Grade 2 and one case (1%) was Grade 3. Adjudicated immune effector cell-associated neurotoxicity syndrome (ICANS) events of any grade occurred in 8% of patients, including three cases that were Grade 3 and no cases that were ≥Grade 4. Infections occurred in 74% of patients – including 36% that were Grade 3 or 4 – and decreased in frequency and severity after 6 months. The most common Grade 3 or 4 TEAEs (≥20%) were neutropenia (42%) and anemia (31%). Six deaths considered due to TEAEs by investigators occurred on treatment or within 30 days of the last treatment dose; five were due to infection, and one was due to renal failure.

Also shared at EHA was a retrospective study comparing outcomes of linvoseltamab 200 mg Phase 2 patients (N=105) in LINKER-MM1 at 14-months of median follow-up to those of real-world external control patients (N=101) who received standard-of-care (SOC) treatment in clinical practice (approximately 80 varied regimens). Patients receiving SOC treatment also met similar inclusion/exclusion criteria to the LINKER-MM1 trial. Comparing linvoseltamab to SOC treatment, the ORR was 70% versus 32% (odds ratio [OR] 5.4), median PFS was 20 months versus 3 months (hazard ratio [HR]: 0.23), and median OS was not reached versus 12 months (HR: 0.40).

In the U.S., linvoseltamab has been granted Fast Track Designation and was accepted for Priority Review for the treatment of R/R MM by the U.S. Food and Drug Administration with a target action date of August 22, 2024. Linvoseltamab is also under review for R/R MM by the European Medicines Association.

The Phase 3 confirmatory trial (LINKER-MM3) for linvoseltamab in patients with R/R MM is ongoing. Linvoseltamab is currently under clinical development, and its safety and efficacy have not been fully evaluated by any regulatory authority.

About Multiple Myeloma
As the second most common blood cancer, there are over 176,000 new cases of MM diagnosed globally, and 35,000 cases are diagnosed in the U.S. every year. In the U.S., there are approximately 8,000 people who have MM that has progressed after three lines of therapy, and 4,000 whose disease has progressed after four or more therapies. The disease is characterized by the proliferation of cancerous plasma cells (MM cells) that crowd out healthy blood cells in the bone marrow, infiltrate other tissues and cause potentially life-threatening organ injury. Despite treatment advances, MM is not curable and while current treatments are able to slow progression of the cancer, most patients will ultimately experience cancer progression and require additional therapies.

About the Linvoseltamab Phase 1/2 Trial and Clinical Development Program
The ongoing, open-label, multicenter Phase 1/2 dose-escalation and dose-expansion LINKER-MM1 trial is investigating linvoseltamab in 282 enrolled patients with relapsed/refractory MM. The Phase 1 dose-escalation portion of the trial – which is now complete – primarily assessed safety, tolerability and dose-limiting toxicities across nine dose levels of linvoseltamab and explored different administration regimens. The ongoing Phase 2 dose expansion portion is assessing the safety and anti-tumor activity of linvoseltamab, with the primary endpoint of ORR. Key secondary endpoints include DoR, PFS, rate of minimum residual disease (MRD) negative status and OS.

Eligibility in the Phase 2 portion requires patients to have received at least three prior lines of therapy or have triple-class refractory MM. Linvoseltamab is administered with an initial step-up dosing regimen followed by the full 200 mg dose administered weekly. At week 16, all patients transition to every two-week dosing. A response-adapted regimen further enables patients to shift to every four-week dosing if they achieve a VGPR or better and have completed at least 24 weeks of therapy. The regimen requires a total of two 24-hour hospitalizations for safety monitoring.

The broader linvoseltamab clinical development program includes additional trials in earlier lines of therapy and stages of disease that are planned or underway. They include a Phase 1/2 trial in first-line MM, a Phase 2 trial in high-risk smoldering MM, and a Phase 2 trial in monoclonal gammopathy of undetermined significance. A Phase 1 trial of linvoseltamab in combination with a Regeneron CD38xCD28 costimulatory bispecific in MM is also planned. For more information, visit the Regeneron clinical trials website, or contact via clinicaltrials@regeneron.com or 844-734-6643.

About Regeneron in Hematology
At Regeneron, we’re applying more than three decades of biology expertise with our proprietary VelociSuite^® technologies to develop medicines for patients with diverse blood cancers and rare blood disorders.

Our blood cancer research is focused on bispecific antibodies that are being investigated both as monotherapies and in various combinations and emerging therapeutic modalities. Together, they provide us with unique combinatorial flexibility to develop customized and potentially synergistic cancer treatments.

Our research and collaborations to develop potential treatments for rare blood disorders include explorations in antibody medicine, gene editing and gene-knockout technologies, and investigational RNA-approaches focused on depleting abnormal proteins or blocking disease-causing cellular signaling.

About Regeneron
Regeneron (NASDAQ: REGN) is a leading biotechnology company that invents, develops and commercializes life-transforming medicines for people with serious diseases. Founded and led by physician-scientists, our unique ability to repeatedly and consistently translate science into medicine has led to numerous approved treatments and product candidates in development, most of which were homegrown in our laboratories. Our medicines and pipeline are designed to help patients with eye diseases, allergic and inflammatory diseases, cancer, cardiovascular and metabolic diseases, neurological diseases, hematologic conditions, infectious diseases, and rare diseases. 

Regeneron pushes the boundaries of scientific discovery and accelerates drug development using our proprietary technologies, such as VelociSuite^®, which produces optimized fully human antibodies and new classes of bispecific antibodies. We are shaping the next frontier of medicine with data-powered insights from the Regeneron Genetics Center^® and pioneering genetic medicine platforms, enabling us to identify innovative targets and complementary approaches to potentially treat or cure diseases.

For more information, please visit www.Regeneron.com or follow Regeneron on LinkedIn, Instagram, Facebook or X.

Forward-Looking Statements and Use of Digital Media
This press release includes forward-looking statements that involve risks and uncertainties relating to future events and the future performance of Regeneron Pharmaceuticals, Inc. (“Regeneron” or the “Company”), and actual events or results may differ materially from these forward-looking statements. Words such as “anticipate,” “expect,” “intend,” “plan,” “believe,” “seek,” “estimate,” variations of such words, and similar expressions are intended to identify such forward-looking statements, although not all forward-looking statements contain these identifying words. 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FAQ

What was the overall response rate of linvoseltamab in the LINKER-MM1 trial?

The overall response rate (ORR) was 71%.

How many patients achieved a complete response or better with linvoseltamab?

50% of patients achieved a complete response (CR) or better.

What was the median duration of response for linvoseltamab?

The median duration of response (DoR) was 29 months.

What was the median overall survival for patients treated with linvoseltamab?

The median overall survival (OS) was 31 months.

When will the FDA make a decision on linvoseltamab's approval?

The FDA's decision is expected by August 22, 2024.

What were the most common adverse events in the linvoseltamab trial?

The most common adverse events were cytokine release syndrome (CRS) and infections.

How did linvoseltamab perform compared to real-world standard-of-care treatments?

Linvoseltamab showed better outcomes compared to real-world standard-of-care treatments, with higher response rates and longer survival times.

Is linvoseltamab under review in Europe?

Yes, linvoseltamab is under review by the European Medicines Association.

What stage of clinical development is linvoseltamab currently in?

Linvoseltamab is currently in a Phase 3 confirmatory trial.