New Bispecific Antibody Linvoseltamab Now Available for Multiple Myeloma Treatment

A new therapeutic option has become available for adults with relapsed and refractory multiple myeloma, a form of blood cancer that remains incurable and aggressive. Linvoseltamab, marketed as Lynozyfic® (5 mg/200 mg concentrate for infusion, by Regeneron), is a bispecific antibody designed to address cases where patients have already undergone at least three prior lines of therapy, including an immunomodulator, a proteasome inhibitor, and an anti-CD38 antibody, and whose disease has progressed despite these treatments.

Multiple myeloma is characterized by the malignancy of plasma cells in the bone marrow, which typically play a crucial role in antibody production and immune defense. Patients with this disease often develop resistance to standard therapies, creating a need for innovative treatments that can target the cancer cells through new mechanisms.

Linvoseltamab operates as a bispecific antibody, simultaneously binding to the CD3 protein found on T-cells and the B-cell maturation antigen (BCMA) expressed on malignant plasma cells, mature B-cells, and healthy plasma cells. By connecting these two cell types, the medication brings T-cells into close proximity with the myeloma cells, prompting the immune system to recognize and attack the cancerous cells directly.

This treatment is administered as an intravenous infusion, following a structured dosing schedule. The initial dose of 5 mg is given in the first week, followed by 25 mg in the second week. By the third week, patients receive the full therapeutic dose of 200 mg. From the fourth to the thirteenth week, the 200 mg dose is administered weekly. After this induction period, the therapy continues every two weeks from week 14, with the possibility of extending to four-week intervals from week 24 based on patient response and tolerability.

To reduce the risk of infusion-related reactions, patients are premedicated with dexamethasone, an antihistamine, and paracetamol one to three hours prior to each infusion. This premedication protocol should be maintained until at least two complete doses have been tolerated without significant adverse effects. The treatment is continued until either disease progression is observed or unacceptable toxicity occurs.

Linvoseltamab is intended as a monotherapy for patients who have exhausted other available treatment options. Its mechanism of action, targeting both T-cells and malignant B-cells, represents an important development in immunotherapeutic strategies for multiple myeloma. Healthcare providers should monitor patients closely for potential side effects, including possible alterations in mental status, as part of standard clinical practice.

The introduction of Linvoseltamab adds an innovative therapy to the arsenal against multiple myeloma, aiming to improve outcomes for patients with limited alternatives. Ongoing research and post-marketing surveillance will continue to evaluate its long-term efficacy and safety profile in real-world clinical settings.