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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Elsevier
2025-08-01
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| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952925002666 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Benjamin Adegbite |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-0f2cd3978f0e43f1977a6d693ef26ad0 |
| institution | Kabale University |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
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| series | Blood Advances |
| spelling | doaj-art-0f2cd3978f0e43f1977a6d693ef26ad02025-08-20T03:39:05ZengElsevierBlood Advances2473-95292025-08-019154016402210.1182/bloodadvances.2025015973Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myelomaBenjamin Adegbite0Carlyn Rose Tan1Tala Shekarkhand2Ross S. Firestone3Eric M. Jurgens4Kevin Miller5Alexander M. Lesokhin6Gunjan L. Shah7Neha Korde8Sridevi Rajeeve9Heather J. Landau10Michael Scordo11Hani Hassoun12Kylee H. Maclachlan13Urvi A. Shah14Malin Hultcrantz15Issam S. Hamadeh16Andriy Derkach17David Nemirovsky18Sergio A. Giralt19Sham Mailankody20Saad Z. Usmani21Hamza Hashmi22Department of Medicine, Mount Sinai Morningside/West, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Carlyn Rose Tan, Myeloma and Cell Therapy Service, Memorial Sloan Kettering Cancer Center, 530 East 74th St, New York, NY 10021;Division of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYClinical Pharmacy Services, Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Epidemiology and Biostatistics, Department of Research, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Epidemiology and Biostatistics, Department of Research, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYDivision of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Correspondence: Hamza Hashmi, Myeloma and Cell Therapy Service, Memorial Sloan Kettering Cancer Center, 530 East 74th St, New York, NY 10021;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.http://www.sciencedirect.com/science/article/pii/S2473952925002666 |
| spellingShingle | 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 Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma Blood Advances |
| title | Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma |
| title_full | Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma |
| title_fullStr | Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma |
| title_full_unstemmed | Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma |
| title_short | Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma |
| title_sort | outcomes in frail patients receiving bcma directed bispecific antibodies for relapsed refractory multiple myeloma |
| url | http://www.sciencedirect.com/science/article/pii/S2473952925002666 |
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