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Phase II study of novel CXCR2 agonist and Plerixafor for rapid stem cell mobilization in patients with multiple myeloma.
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Phase II study of novel CXCR2 agonist and Plerixafor for rapid stem cell mobilization in patients with multiple myeloma. Blood cancer journal Sidana, S., Bankova, A. K., Hosoya, H., Kumar, S. K., Holmes, T. H., Tamaresis, J., Le, A., Muffly, L. S., Maysel-Auslender, S., Johnston, L., Arai, S., Lowsky, R., Meyer, E., Rezvani, A., Weng, W. K., Frank, M. J., Shiraz, P., Maecker, H. T., Lu, Y., Miklos, D. B., Shizuru, J. A. 2024; 14 (1): 173Abstract
MGTA-145 or GROßT, a CXCR2 agonist, has shown promising activity for hematopoietic stem cell (HSC) mobilization with plerixafor in pre-clinical studies and healthy volunteers. Twenty-five patients with multiple myeloma enrolled in a phase 2 trial evaluating MGTA-145 and plerixafor for HSC mobilization (NCT04552743). Plerixafor was given subcutaneously followed 2?h later by MGTA-145 (0.03?mg/kg) intravenously with same day apheresis. Mobilization/apheresis could be repeated for a second day in patients who collected <6 ×106 CD34+ cells/kg. Lenalidomide and anti-CD38 antibody were part of induction therapy in 92% (n?=?23) and 24% (n?=?6) of patients, respectively. Median total HSC cell yield (CD34+ cells/kg?×?106) was 5.0 (range: 1.1-16.2) and day 1 yield was 3.4 (range: 0.3-16.2). 88% (n?=?22) of patients met the primary endpoint of collecting 2 ×106 CD34+ cells/kg in = two days, 68% (n?=?17) in one day. Secondary endpoints of collecting 4 and 6?×?106 CD34+ cells/kg in = two days were met in 68% (n?=?17) and 40% (n?=?10) patients. Grade 1 or 2 adverse events (AE) were seen in 60% of patients, the most common AE being grade 1 pain, usually self-limited. All 19 patients who underwent transplant with MGTA-145 and plerixafor mobilized HSCs engrafted successfully, with durable engraftment at day 100. 74% (17 of 23) of grafts with this regimen were minimal residual disease negative by next generation flow cytometry. Graft composition for HSCs and immune cells were similar to a contemporaneous cohort mobilized with G-CSF and plerixafor.
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