UPDATED RESULTS OF SONROTOCLAX + DEXAMETHASONE, AN ALL-ORAL TREATMENT, IN PATIENTS WITH T(11;14)-POSITIVE RELAPSED/REFRACTORY MULTIPLE MYELOMA
Bibliographic record
Abstract
Despite the clinical efficacy of BCL2 inhibition in t(11;14)-positive multiple myeloma (MM), no BCL2-targeted treatments are approved. Sonrotoclax (BGB- 11417), a next-generation BCL2 inhibitor, is a more selective and pharmacologically potent inhibitor of BCL2 than venetoclax, with a shorter half-life and no drug accumulation. BGB-11417-105 (NCT04973605) is an ongoing phase 1b/2 study of sonrotoclax mono- or combination therapy in patients (pts) with t(11;14)-positive relapsed/refractory (R/R) MM. To assess safety and efficacy of sonrotoclax + dexamethasone (dex) in pts from BGB-11417-105. Eligible pts had R/R MM with centrally confirmed t(11;14) and received oral daily sonrotoclax (320 or 640 mg) and weekly dex (40 mg) until end of treatment. Adverse events (AEs) were graded by CTCAE v5.0, and efficacy was assessed by the investigator per IMWG criteria. As of January 20, 2025, 14 and 36 evaluable pts were enrolled in sonrotoclax 320- and 640-mg cohorts, respectively; median (range) follow-up was 6.2 months (2.6- 34.5) and 12.1 months (0.1-28.9), respectively. In the 320- vs 640-mg cohorts, respectively, median age (range) was 69.5 y (44-86) vs 69.0 y (48-80); 42.9% vs 52.8% were male; and 57.1% vs 75.0% were White. Pts had a median of 3 prior treatment lines in both the 320-mg (range, 1-7) and 640-mg (range, 1-12) cohorts; 78.6% and 66.7% of pts were refractory to 3 treatment classes, respectively. At data cutoff, 7 pts (50.0%) in the 320-mg cohort and 14 (38.9%) in the 640-mg cohort remained on treatment; progression was the most common reason for discontinuation (35.7% and 41.7%, respectively). The ORR (95% CI) was 64.3% (35.1%-87.2%) for 320 mg and 80.6% (64.0%-91.8%) for 640-mg, with VGPR or better rates (95% CI) of 35.7% (12.8%-64.9%) and 55.6% (38.1%-72.1%), respectively. The median time to response was 0.7 months in both cohorts. Median (95% CI) duration of response was 5.9 months (1.8-not estimable [NE]) in the 320-mg cohort and 12.2 months (8.3-18.9) in the 640-mg cohort. Median (95% CI) progression- free survival was 6.6 months (2.9-NE) in the 320-mg cohort and 13.3 months (9.0-19.6) in the 640-mg cohort. The safety profile was tolerable and manageable for both cohorts. The most common TEAEs were fatigue (35.7%) in the 320-mg cohort, and insomnia (38.9%) and diarrhea (38.9%, all grade 1 or 2) in the 640-mg cohort. Grade ≥3 TEAEs occurred in 5 pts (35.7%) in the 320-mg cohort and 17 pts (47.2%) in the 640-mg cohort; serious TEAEs occurred in 3 (21.4%) and 10 (27.8%), respectively. Grade ≥3 hematologic TEAEs occurred in 1 (7.1%) and 9 (25.0%) and grade ≥3 infections in 3 (21.4%) and 4 (11.1%) pts, respectively. Two pts (14.3%) in the 320-mg cohort and 2 (5.6%) in the 640-mg cohort died during the treatment-emergent portion of the study for reasons unrelated to sonrotoclax or dex (320-mg: pneumonia RSV and COVID-19; 640- mg: hypoventilation due to lung-involved progressive disease and metastatic pancreatic cancer). Four additional deaths occurred >30 days after the last 640-mg dose. The all-oral combination of sonrotoclax + dex continued to show a tolerable safety profile, with low rates of infection and hematologic toxicity, and promising efficacy, with an 81% ORR in the 640-mg cohort, in this t(11;14)-positive R/R MM population. The study is ongoing; additional treatment combinations with sonrotoclax are being investigated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".