The FDA has granted accelerated approval to linvoseltamab-gcpt (Lynozyfic), a bispecific B-cell maturation antigen (BCMA)-directed CD3 T-cell engager, for adults with relapsed/refractory multiple myeloma who have received at least 4 prior lines of therapy, including a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 monoclonal antibody.1
The FDA based the approval on data from LINKER-MM1 (NCT03761108), an open-label, multicenter, multicohort trial. The trial included patients who had previously received at least 3 prior therapies, including a PI, an IMiD, and an anti-CD38 antibody. The trial excluded patients with prior BCMA-directed bispecific antibody therapy, prior bispecific T-cell–engaging therapy, or prior BCMA CAR T-cell therapy. The efficacy population included 80 patients who had received at least 4 prior lines of therapy, including a PI, an IMiD, and an anti-CD38 monoclonal antibody.
The objective response rate was 70% (95% CI, 59-80). With a median follow-up of 11.3 months among responders, the estimated duration of response was 89% (95% CI, 77-95) at 9 months and 72% (95% CI, 54-84) at 12 months.
The linvoseltamab-gcpt prescribing information includes a boxed warning for life-threatening cytokine release syndrome (CRS) and neurologic toxicity, including immune effector cell–associated neurotoxicity syndrome (ICANS). Among patients who received linvoseltamab-gcpt in the LINKER-MM1 clinical trial at the recommended dose, CRS occurred in 46%, and neurologic toxicity, including ICANS, in 54% of patients. Grade 3 CRS occurred in <1% of patients, and grade 3 or 4 neurologic toxicity occurred in 8%.
Because of the risks of CRS and neurologic toxicity, including ICANS, linvoseltamab-gcpt is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Lynozyfic REMS. Other warnings and precautions include infections, neutropenia, hepatotoxicity, and embryo-fetal toxicity.
The recommended administration of intravenous linvoseltamab-gcpt includes step-up doses of 5 mg, 25 mg, and 200 mg, followed by 200 mg weekly for 10 doses, followed by 200 mg biweekly. In patients who have achieved and maintained a very good partial response or better at or after week 24 and received at least 17 doses of 200 mg, the dosing frequency is decreased to 200 mg every 4 weeks.
Reference
- US Food and Drug Administration. FDA grants accelerated approval to linvoseltamab-gcpt for relapsed or refractory multiple myeloma. July 2, 2025. Accessed August 14, 2025. www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-linvoseltamab-gcpt-relapsed-or-refractory-multiple-myeloma