Linvoseltamab outcomes by frailty status in patients with relapsed/refractory multiple myeloma: a subgroup analysis of the LINKER-MM1 study

Abstract There is a paucity of data in frail patients with multiple myeloma (MM) receiving bispecific antibodies (bsAbs). In LINKER-MM1 (NCT03761108), linvoseltamab (human BCMA×CD3 bsAb) demonstrated high response rates and a generally manageable safety profile in relapsed/refractory (RR)MM. This LINKER-MM1 post hoc analysis evaluated outcomes of linvoseltamab 200 mg in patients categorized for frailty using the International Myeloma Working Group Frailty Proxy (IMWG-FP), Simplified Frailty Score (SFS), and patient-reported frailty phenotype (PRFP). As of July 23, 2024, 117 patients received linvoseltamab (median follow-up: 21.3 months). The percentage of frail patients varied by measure: IMWG-FP, 27.4%; SFS, 26.5%; and PRFP, 20.5% (8/4 patients were excluded due to missing IMWG-FP/PRFP scores, respectively). Objective response rates in non-frail and frail groups, respectively, were: IMWG-FP, 72.7% and 65.6%; SFS, 69.8% and 74.2%; PRFP, 73.0% and 62.5%. Incidence of Grade 3/4 treatment-emergent adverse events was consistent across non-frail and frail groups (IMWG-FP: 72.7% and 75.0%; SFS%: 73.3% and 74.2; PRFP: 74.2% and 70.8, respectively). Clinical outcomes were consistent in non-frail and frail groups, indicating a favorable risk–benefit profile for linvoseltamab in the frail patients with RRMM from LINKER-MM1. Continued evaluation of linvoseltamab in frail patients with RRMM in clinical trials and real-world settings is warranted.