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689 Pharmacodynamic results with talquetamab and daratumumab in patients with relapsed/refractory multiple myeloma in TRIMM-2

2023· article· en· W4388042528 on OpenAlexaff
Deeksha Vishwamitra, Sheri Skerget, M. Damiette Smit, Lien Vandenberk, Kalpana Bakshi, Sangmin Lee, Bhagirathbhai Dholaria, María‐Victoria Mateos, Ajai Chari, Paula Rodríguez‐Otero, Nizar J. Bahlis, Niels WCJ van de Donk, Raluca Verona

Bibliographic record

VenueRegular and Young Investigator Award Abstracts · 2023
Typearticle
Languageen
FieldMedicine
TopicCAR-T cell therapy research
Canadian institutionsInstitute of Cancer ResearchUniversity of Calgary
Fundersnot available
KeywordsDaratumumabMedicineCD38PharmacodynamicsInternal medicineMultiple myelomaCD8OncologyRefractory (planetary science)AntibodyMonoclonal antibodyPharmacologyImmunologyGastroenterologyBortezomibImmune systemPharmacokineticsStem cellBiologyCD34

Abstract

fetched live from OpenAlex

<h3>Background</h3> Talquetamab is a T-cell redirecting bispecific antibody targeting G protein-coupled receptor family C group 5 member D and CD3. Daratumumab is an anti-CD38 monoclonal antibody with direct on-tumor and immunomodulatory actions. The phase 1b TRIMM-2 (NCT04108195) trial showed that talquetamab + daratumumab had deep (overall response rate [ORR] of 71–84%) and durable responses, with promising ORRs in unmet need subgroups (anti-CD38 refractory and prior T-cell redirection exposed), and a manageable safety profile in patients with relapsed/refractory multiple myeloma (RRMM). We present pharmacodynamic results from TRIMM-2 to support and elucidate the potential immunomodulatory mechanisms of action (MOA) of talquetamab + daratumumab. <h3>Methods</h3> Patients had MM, ≥3 prior lines of therapy (including a proteasome inhibitor [PI] and immunomodulatory drug [IMiD]) or were double refractory to a PI and IMiD and had not received anti-CD38 therapy in ≤90 days. Patients received the recommended phase 2 doses of talquetamab, 0.4 mg/kg weekly or 0.8 mg/kg biweekly with step-up doses, + daratumumab 1800 mg per the approved schedule. Whole blood from patients in TRIMM-2 was analyzed for immune populations by flow cytometry. T-cell clonality was analyzed by T-cell receptor sequencing. <h3>Results</h3> Patients who received talquetamab + daratumumab demonstrated T-cell redistribution (early reduction in peripheral CD3+ T cells) and subsequent T-cell recovery, consistent with the MOA of each agent. A high level of clonal expansion was observed at cycle 3, day 1 vs baseline, including a significant increase in the fraction of newly detected clones, indicative of antigen-specific T-cell activation. Talquetamab + daratumumab led to a moderate increase in effector memory CD8+ T cells and induction of T-cell activation, as evidenced by an increase in LAG-3+, TIM-3+, and PD-1+ CD8+ T cells in the first cycle. An initial reduction of CD38+CD8+ T cells was observed after daratumumab administration; however, following talquetamab administration, induction of CD38+CD8+ T cells was observed, indicative of T-cell activation. Consistent with daratumumab’s MOA, there was a notable reduction in immunosuppressive CD38+ regulatory T cells (Tregs) with the combination and a sustained reduction in natural killer cells. There was no reduction in total CD19+ B cells. <h3>Conclusions</h3> The pharmacodynamic profile of talquetamab + daratumumab was consistent with the respective MOAs and showed induction of T-cell activation, an increase in T-cell clonality, and reduction of immunosuppressive CD38+ Tregs. These data support the promising efficacy of this off-the-shelf immunotherapy combination in patients with RRMM. <h3>Acknowledgements</h3> This study was funded by Janssen Research &amp; Development, LLC. Medical writing support was provided by Rachael Smith, PhD, of Eloquent Scientific Solutions, and funded by Janssen Global Services, LLC. <h3>Trial Registration</h3> NCT04108195 <h3>Ethics Approval</h3> Conducted in accordance with the principles of the Declaration of Helsinki and the International Council for Harmonization’s Good Clinical Practice guidelines. Protocol/amendments were approved by each site’s Institutional Review Board. All patients provided informed written consent.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.036
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.014
GPT teacher head0.255
Teacher spread0.241 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2023
Admission routes1
Has abstractyes

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