Adding motixafortide to granulocyte colony-stimulating factor (G-CSF) increases mobilization of CD34+ hematopoietic stem and progenitor cells (HSPCs) in patients with multiple myeloma (MM), according to research published in Nature Medicine.

Researchers tested motixafortide plus G-CSF in a phase 3 trial of 122 MM patients undergoing autologous stem cell transplant (ASCT) between 2018 and 2020 at 18 sites in 5 countries ( Identifier: NCT03246529).

The patients were randomly assigned in a 2:1 ratio to receive motixafortide (80 patients) or placebo (42 patients) plus G-CSF. Baseline characteristics were similar between the arms.

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The primary endpoint of collecting at least 6 × 106 CD34+ cells kg–1 within 2 apheresis days was met by 92.5% of patients in the motixafortide arm and 26.2% of those in the placebo arm (odds ratio [OR], 53.3; 95% CI, 14.12-201.33; P <.0001).

The secondary endpoint of collecting at least 6 × 106 CD34+ cells kg–1 in 1 apheresis day was met by 88.8% of patients in the motixafortide arm and 9.5% of those in the placebo arm (OR, 118.0; 95% CI, 25.36-549.35; P <.0001).

Treatment-emergent adverse events (TEAEs) occurred in 93.8% of patients in the motixafortide arm and 83.3% in the placebo arm. The rate of grade 3 TEAEs was 27.5% and 4.8%, respectively.

The most common TEAEs related to motixafortide were grade 1-2 local injection site reactions and systemic reactions. Local reactions included pain (50%), erythema (27.5%), and pruritis (21.3%). Systemic reactions included flushing (32.5%), pruritis (33.8%), urticaria (12.5%), and erythema (12.5%).

“[T]he upfront use of a single injection of motixafortide added to G-CSF resulted in rapid, robust, and reliable mobilization of optimal numbers of CD34+ HSPCs in patients with MM undergoing ASCT,” the researchers concluded.

Disclosures: This research was supported by BioLineRx. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Crees ZD, Rettig MP, Jayasinghe RG, et al. Motixafortide and G-CSF to mobilize hematopoietic stem cells for autologous transplantation in multiple myeloma: A randomized phase 3 trial. Nat Med. 2023;29(4):869-879. doi:10.1038/s41591-023-02273-z

This article originally appeared on Oncology Nurse Advisor