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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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.
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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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