New add-on therapy may help delay worsening in hard-to-treat myeloma

Adding the experimental anti-CD38 therapy felzartamab reduced the risk of disease progression among people with hard-to-treat myeloma in a Phase 3 clinical trial conducted at 41 hospitals in China.

The trial enrolled nearly 300 adults with myeloma that was relapsed or refractory — meaning the disease had failed to respond, or had come back after initially responding — after one or more prior lines of treatment. Participants were randomly assigned to receive Revlimid (lenalidomide) and dexamethasone, either alone or with add-on felzartamab. People whose disease was refractory to lenalidomide were not eligible for the trial.

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Sept. 28, 2026 by Marisa Horak, MS

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Add-on felzartamab lengthens progression-free survival

Results showed that median progression-free survival was 10.4 months with standard therapy alone, compared with 18.9 months when felzartamab was added.

“The findings support felzartamab plus [Revlimid]–dexamethasone as an effective treatment option for Chinese patients with relapsed or refractory multiple myeloma,” researchers wrote. They said it was the first and largest randomized Phase 3 trial to evaluate an anti-CD38 antibody-based regimen exclusively in Chinese patients with relapsed or refractory myeloma.

Full results from the trial were published in The Lancet Haematology, in a study titled “Felzartamab plus lenalidomide–dexamethasone versus lenalidomide–dexamethasone for relapsed or refractory multiple myeloma: an open-label, parallel-controlled, randomised, phase 3 trial.”

The study was funded by TJ Biopharma, which participated in the study design, data collection, analysis, interpretation, and writing of the report. Five study authors were TJ Biopharma employees. In April, Biogen agreed to acquire TJ Biopharma’s rights to felzartamab in Greater China, giving Biogen exclusive worldwide rights to the therapy.

Myeloma is a form of blood cancer marked by the abnormal growth of plasma cells, a specific type of immune cell. Anti-CD38 antibodies are a standard class of myeloma therapies that target CD38, a protein expressed by plasma cells.

How felzartamab targets myeloma cells

Anti-CD38 antibodies bind to CD38 on myeloma cells and can recruit different parts of the immune system to destroy them. Felzartamab maintains strong activity through mechanisms in which immune cells attack or engulf myeloma cells, while having much less activity through the complement system, a group of proteins that can also help kill targeted cells. Researchers said this balance may preserve felzartamab’s cancer-killing activity while reducing some limitations linked to complement activation.

“Rather than replacing therapies with different mechanisms of action, felzartamab represents an effort to optimise an already well established therapeutic target and might provide an additional treatment option for biologically selected patients who are less likely to benefit from conventional [complement-dependent CD38 antibodies],” the researchers wrote.

The main goal of this study was to evaluate whether add-on felzartamab improved progression-free survival (PFS), defined as the time patients remain alive without disease progression. Median PFS was 10.4 months with dexamethasone and Revlimid alone and was significantly longer, at 18.9 months, when felzartamab was added.

Safety data were broadly consistent with the known profile of anti-CD38 antibodies given in combination with dexamethasone and Revlimid. The most common grade 3 or 4 adverse events included low blood cell counts and pneumonia.

“In conclusion, felzartamab plus [Revlimid]–dexamethasone significantly prolonged progression-free survival and showed a manageable adverse event profile in Chinese patients with relapsed or refractory multiple myeloma,” the scientists wrote.