Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma

Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma

Abstract: Patients with relapsed/refractory (R/R) multiple myeloma (MM) are often frail with preexisting comorbidities and poor performance status (PS). To evaluate clinical characteristics and outcomes based on frailty, we conducted a single-center retrospective study of patients with R/R MM who re...

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Main Authors: Benjamin Adegbite, Carlyn Rose Tan, Tala Shekarkhand, Ross S. Firestone, Eric M. Jurgens, Kevin Miller, Alexander M. Lesokhin, Gunjan L. Shah, Neha Korde, Sridevi Rajeeve, Heather J. Landau, Michael Scordo, Hani Hassoun, Kylee H. Maclachlan, Urvi A. Shah, Malin Hultcrantz, Issam S. Hamadeh, Andriy Derkach, David Nemirovsky, Sergio A. Giralt, Sham Mailankody, Saad Z. Usmani, Hamza Hashmi
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952925002666
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Summary:Abstract: Patients with relapsed/refractory (R/R) multiple myeloma (MM) are often frail with preexisting comorbidities and poor performance status (PS). To evaluate clinical characteristics and outcomes based on frailty, we conducted a single-center retrospective study of patients with R/R MM who received B-cell maturation antigen (BCMA)–directed bispecific antibodies (BsAbs). Frailty was defined using the simplified frailty index based on age, Eastern Cooperative Oncology Group (ECOG) PS, and Charlson comorbidity index (CCI; nonfrail score 0-1 and frail score ≥2). Of 102 patients analyzed (age range, 40-88 years), 40 (39%) were considered frail. The frail group had more patients aged ≥70 years (73% vs 29%; P < .001), with ECOG PS ≥2 (36% vs 0%; P < .001), and worse median CCI (2 vs 1; P < .001). Patients in the frail group experienced similar rates of all-grade cytokine release syndrome (58% vs 60%; P = .99), immune effector cell–associated neurotoxicity syndrome (15% vs 8%; P = .44), and treatment-related mortality (13% vs 21%; P = .27) compared to the nonfrail group. The best overall response rate was 80% (stringent complete response [sCR]/CR, 15%; very good partial response [VGPR], 48%) in the frail group vs 73% (sCR/CR, 23%; VGPR, 31%) in the nonfrail group (P = .40). With a median follow-up of 8.6 months (range, 3-14), there was no significant difference in median progression-free survival (not reached vs 11 months; P = .051) or overall survival (37 vs 25 months; P = .37) between the frail and nonfrail groups. Hence, BsAbs were deemed safe and effective for older and frail patients with R/R MM.
ISSN:2473-9529

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