Linvoseltamab, a BCMA-directed CD3 T-cell engager for multiple myeloma: a patient-centric option via a response-adapted dosing regimen

INTRODUCTION: Despite advances in the treatment of multiple myeloma (MM), there remains a significant need for new modalities, mechanisms of action (MOA), and combinations to achieve durable remissions. Bispecific T-cell engagers (BiTEs), particularly those targeting B-cell maturation antigen (BCMA), have demonstrated robust outcomes in patients with progression through multiple lines of therapy. Linvoseltamab, a novel BCMAxCD3 bispecific, was recently the FDA and EMA-approved based on the LINKER-MM1 trial for the treatment of patients with relapsed or refractory multiple myeloma (RRMM) who have progressed beyond four lines of therapy. AREAS COVERED: We will discuss the MOA, pharmacokinetics, efficacy, and toxicity of linvoseltamab compared with other approved BiTEs. We will highlight linvoseltamab's patient-centric dosing regimen and improved side effect profile, and we will review published indirect efficacy comparisons with other approved BCMA directed therapies. EXPERT OPINION: Linvoseltamab is the fourth FDA approved bispecific antibody for the treatment of RRMM in patients who have received four or more lines of therapy. Cross-trial comparisons ave suggested that linvoseltamab has comparable to slightly better efficacy compared with other agents. Linvoseltamab offers an optimized dosing regimen with a favorable CRS profile. Further real-world data are needed to understand linvoseltamab's role within the MM treatment paradigm.