Background: B-cell maturation antigen (BCMA) bispecific antibodies have advanced treatment of relapsed/refractory multiple myeloma (RRMM), but comparative data are lacking.
Methods: An unanchored matching-adjusted indirect comparison (MAIC) was conducted between linvoseltamab and teclistamab in triple-class exposed (TCE) RRMM using patient-level data from LINKER-MM1 (117 patients, linvoseltamab 200 mg, data cutoff 1/2024, median follow-up [mFU] 14.3 months) and aggregate data from MajesTEC-1 (165 patients, teclistamab 1.5 mg/kg, data cutoff 2/2022, mFU 14.1 months). Ten LINKER-MM1 patients with prior BCMA antibody-drug conjugate exposure were excluded to match MajesTEC-1 eligibility criteria. LINKER-MM1 patients were weighted to match MajesTEC-1 on 6 prespecified prognostic factors considered most important by an international MM expert panel.
Results: After matching (effective sample size = 83.0), linvoseltamab showed significantly longer progression-free survival (PFS, P = .004), overall survival (OS, P = .039), and time to next treatment (P = .028), and numerically longer duration of response ((P = .100) than teclistamab based on hazard ratios. Linvoseltamab demonstrated numerically higher objective response rate, very good partial response or better, complete response or better (≥CR), and minimal residual disease-negativity (10-5 threshold) rates versus teclistamab based on odds ratios. Additional MAICs matching all prognostic factors available in both trials showed significantly longer PFS (P = .038) and OS (P = .039), significantly higher ≥CR (P = .043), and favorable trends for all other outcomes.
Conclusion: This analysis demonstrated statistically improved PFS and OS and numerically favorable results for all other outcomes for linvoseltamab versus teclistamab in the treatment of TCE RRMM.
Keywords: Bispecific antibodies; Clinical efficacy; Linvoseltamab; Relapsed/refractory multiple myeloma; Teclistamab.
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