New drug combination shows promise for treating transplant ineligible Multiple Myeloma patients

Diagram shows signs and symptoms of Multiple Myeloma – Image credit Multiple Myeloma Foundation

CANCER DIGEST – June 8, 2025 – The initial results of a phase 3 clinical trial for a bone marrow cancer show that a three-drug combination achieved a high response rate with manageable side effects in patients who are not eligible for stem cell transplants. The results were presented June 2, 2025 at the annual conference of the Association of Clinical Oncologists (ASCO) in Chicago.

The international clinical trial called MagnetisMM-6 led by Dr. Hang Quach of the University of Melbourne, Australia involved 37 patients who were too old or frail for stem cell transplants who underwent a combination therapy using antibody drugs elranatamab in combination with lenalidomide and daratumumab compared to 34 similar patients who received standard of care combination of lenalidomide, daratumumab and dexamethasone.

Multiple myeloma is a cancer of the bone marrow that results in abnormal plasma cells, which are responsible for making antibodies. In multiple myeloma, the cancerous plasma cells produce a protein call M protein that causes bone pain, fractures, infections and kidney failure. In addition, the cancerous cells crowd out other bone marrow cells including platelets needed for clotting, and red and white blood cells needed for carrying nutrients throughout the body and fighting infections. 

It is normally treated with stem cell transplantation that replaces the patient’s bone marrow with donor marrow. However, patients who are too old or have other illnesses are considered ineligible for the arduous treatment needed for a stem cell transplant. For those patients a combination of therapies are used to manage the disease but not cure it. Taken altogether, with stem cell transplants and other therapies about 63 percent of MM patients survive 5 years or more, and it is twice as common and twice as likely to be fatal in black men, according to the National Cancer Institute.

In this clinical trial all of the patients had relapsed or did not respond to initial treatments. The group that received the combination of elranatamab, lenalidomnide and daratumumab achieved an overall response rate of 97.3% with 94.6% having very good or partial responses and 27% having a complete response. A good or partial response means the cancer is substantially or partly reduced, a complete response means there is no sign of cancer after the treatment. 

All of the patients experienced side effects including changes in blood cell counts, bleeding, anemia, infections, which were managed with standard drugs.

While the trial shows the combination treatment improves response rates, it is too early to tell if that will translate into a long-term response that could extend survival. The next step will be to extend the type of patients treated and expand the number of patients in the trial.

Sources: ASCO press release and ASCO abstract