Comparative efficacy of linvoseltamab versus teclistamab in triple-class exposed (TCE) relapsed/refractory multiple myeloma (RRMM): Updated matching-adjusted indirect comparison (MAIC) with longer follow-up.

Abstract

7526 Background: Linvoseltamab and teclistamab are anti-B-cell maturation antigen (BCMA)×CD3 bispecific antibodies evaluated in the LINKER-MM1 and MajesTEC-1 trials, respectively, and approved for TCE RRMM. In the absence of head-to-head trials, a previous MAIC assessed their relative efficacy at ~14-month median follow-up (mFU). We present updated results with longer follow-up for both trials. Methods: After excluding 10 patients (pts) with prior BCMA antibody–drug conjugate exposure from LINKER-MM1 to align with MajesTEC-1 eligibility, pt-level data from LINKER-MM1 (linvoseltamab 200 mg, N=107; data cut-off [DCO] July 2024; mFU 21.3 months) and aggregate data from MajesTEC-1 (N=165; DCO August 2023; mFU 30.4 months) were used. LINKER-MM1 pts were weighted to match MajesTEC-1 using prespecified prognostic factors, as described previously (Lee et al., Clin Lymphoma Myeloma Leuk 2025;25:897–909). MAICs were rerun for objective response rate (ORR), very good partial response or better (≥VGPR) rate, complete response or better (≥CR) rate, duration of response (DOR), progression-free survival (PFS), overall survival (OS) and time to next treatment (TTNT). Treatment effects were estimated using odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs). Restricted mean survival time (RMST) was evaluated at 30 months. Results: In both unadjusted comparisons and MAICs adjusted for 6 key prognostic factors (cytogenetic risk, age, refractory status, ISS stage, ECOG score, extramedullary disease/plasmacytoma status; effective sample size 82.5), linvoseltamab showed numerically higher ORR, ≥VGPR, and ≥CR rates and significantly longer DOR, PFS, OS, and TTNT vs teclistamab (Table). Compared with prior MAICs with shorter follow-up, adjusted HRs for DOR and TTNT further decreased in favor of linvoseltamab, while other results remained stable. Conclusions: With longer follow-up, linvoseltamab continued to demonstrate comparative efficacy advantages vs teclistamab, reinforcing its potential as an effective treatment option for TCE RRMM. Outcome, linvoseltamab vs teclistamab Unadjusted Adjusted for 6 key prognostic factors OR (95% CI) OR (95% CI) ORR 1.44 (0.97–2.13) 1.50 (0.97–2.32) ≥VGPR 1.19 (0.83–1.72) 1.17 (0.79–1.74) ≥CR 1.29 (0.91–1.82) 1.21 (0.83–1.76) HR (95% CI); RMST difference, months (95% CI) HR (95% CI); RMST difference, months (95% CI) DOR 0.58 (0.36–0.96)*;3.66 (0.77–6.55)* 0.54 (0.31–0.92)*;4.06 (1.13–6.98)* PFS 0.57 (0.40–0.82)*;5.13 (2.01–8.25)* 0.55 (0.36–0.82)*;5.43 (2.04–8.81)* OS 0.68 (0.47–0.98)*;2.99 (0.22–5.75)* 0.64 (0.43–0.97)*;3.06 (0.08–6.04)* TTNT 0.42 (0.28–0.62)*;7.10 (4.27–9.94)* 0.41 (0.27–0.64)*;7.12 (4.15–10.09)* *p<0.05. OR >1, HR <1, or RMST >0 indicate better efficacy with linvoseltamab vs teclistamab.