Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study
Background: The development of newer agents, including anti-CD38 monoclonal antibodies (mAbs), has significantly improved overall survival (OS) in patients with relapsed or refractory multiple myeloma (RRMM). However, the treatment of older patients with RRMM who are transplant-ineligible remains ch...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-11-01
|
| Series: | Hematology Reports |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2038-8330/16/4/68 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850040898594799616 |
|---|---|
| author | Satoshi Yamasaki Michitoshi Hashiguchi Nao Yoshida-Sakai Hiroto Jojima Koichi Osaki Takashi Okamura Yutaka Imamura |
| author_facet | Satoshi Yamasaki Michitoshi Hashiguchi Nao Yoshida-Sakai Hiroto Jojima Koichi Osaki Takashi Okamura Yutaka Imamura |
| author_sort | Satoshi Yamasaki |
| collection | DOAJ |
| description | Background: The development of newer agents, including anti-CD38 monoclonal antibodies (mAbs), has significantly improved overall survival (OS) in patients with relapsed or refractory multiple myeloma (RRMM). However, the treatment of older patients with RRMM who are transplant-ineligible remains challenging. Methods: We retrospectively evaluated OS in 78 transplant-ineligible patients with RRMM who were aged ≥ 65 years and treated at our institution between February 2012 and November 2023. Results: Unadjusted OS was significantly longer in the anti-CD38 mAb-exposed group (i.e., those previously treated with daratumumab and receiving isatuximab plus pomalidomide and low-dose dexamethasone because of disease progression during treatment with daratumumab [<i>n</i> = 6], daratumumab plus pomalidomide and low-dose dexamethasone [<i>n</i> = 9], or isatuximab plus pomalidomide and low-dose dexamethasone without daratumumab-exposure [<i>n</i> = 14]) than in the anti-CD38 mAb-naïve group (no exposure to daratumumab or isatuximab [<i>n</i> = 49]) (<i>p</i> < 0.001). To address potential confounder factors associated with use or nonuse of anti-CD38 mAbs, we performed propensity score matching (PSM) using age, sex, performance status, and Geriatric 8 and Instrumental Activities of Daily Living scores. PSM identified 14 subjects from the anti-CD38 mAb-exposed group with baseline characteristics similar to those of 14 subjects from the anti-CD38 mAb-naïve group. After PSM, the adjusted OS was significantly longer in the anti-CD38 mAb-exposed group than in the anti-CD38 mAb-naïve group (<i>p</i> < 0.001). Conclusion: These findings provide insights into the optimal use of anti-CD38 mAbs in patients with RRMM who are transplant-ineligible and aged ≥65 years and on candidates who are appropriate for novel approaches, such as chimeric antigen receptor T-cell or bispecific T-cell engager therapy. |
| format | Article |
| id | doaj-art-67e0d55cfd14497684aeec47afeeea10 |
| institution | DOAJ |
| issn | 2038-8330 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj-art-67e0d55cfd14497684aeec47afeeea102025-08-20T02:55:57ZengMDPI AGHematology Reports2038-83302024-11-0116471472310.3390/hematolrep16040068Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched StudySatoshi Yamasaki0Michitoshi Hashiguchi1Nao Yoshida-Sakai2Hiroto Jojima3Koichi Osaki4Takashi Okamura5Yutaka Imamura6Department of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Transfusion Medicine, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanDepartment of Hematology, St. Mary’s Hospital, Kurume 830-8543, JapanBackground: The development of newer agents, including anti-CD38 monoclonal antibodies (mAbs), has significantly improved overall survival (OS) in patients with relapsed or refractory multiple myeloma (RRMM). However, the treatment of older patients with RRMM who are transplant-ineligible remains challenging. Methods: We retrospectively evaluated OS in 78 transplant-ineligible patients with RRMM who were aged ≥ 65 years and treated at our institution between February 2012 and November 2023. Results: Unadjusted OS was significantly longer in the anti-CD38 mAb-exposed group (i.e., those previously treated with daratumumab and receiving isatuximab plus pomalidomide and low-dose dexamethasone because of disease progression during treatment with daratumumab [<i>n</i> = 6], daratumumab plus pomalidomide and low-dose dexamethasone [<i>n</i> = 9], or isatuximab plus pomalidomide and low-dose dexamethasone without daratumumab-exposure [<i>n</i> = 14]) than in the anti-CD38 mAb-naïve group (no exposure to daratumumab or isatuximab [<i>n</i> = 49]) (<i>p</i> < 0.001). To address potential confounder factors associated with use or nonuse of anti-CD38 mAbs, we performed propensity score matching (PSM) using age, sex, performance status, and Geriatric 8 and Instrumental Activities of Daily Living scores. PSM identified 14 subjects from the anti-CD38 mAb-exposed group with baseline characteristics similar to those of 14 subjects from the anti-CD38 mAb-naïve group. After PSM, the adjusted OS was significantly longer in the anti-CD38 mAb-exposed group than in the anti-CD38 mAb-naïve group (<i>p</i> < 0.001). Conclusion: These findings provide insights into the optimal use of anti-CD38 mAbs in patients with RRMM who are transplant-ineligible and aged ≥65 years and on candidates who are appropriate for novel approaches, such as chimeric antigen receptor T-cell or bispecific T-cell engager therapy.https://www.mdpi.com/2038-8330/16/4/68older patientsmultiple myelomarelapsed or refractorydaratumumabisatuximabpropensity score matching analysis |
| spellingShingle | Satoshi Yamasaki Michitoshi Hashiguchi Nao Yoshida-Sakai Hiroto Jojima Koichi Osaki Takashi Okamura Yutaka Imamura Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study Hematology Reports older patients multiple myeloma relapsed or refractory daratumumab isatuximab propensity score matching analysis |
| title | Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study |
| title_full | Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study |
| title_fullStr | Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study |
| title_full_unstemmed | Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study |
| title_short | Efficacy of Anti-CD38 Monoclonal Antibodies for Relapsed or Refractory Multiple Myeloma in Stem Cell Transplant-Ineligible Patients Aged over 65 Years: A Propensity Score-Matched Study |
| title_sort | efficacy of anti cd38 monoclonal antibodies for relapsed or refractory multiple myeloma in stem cell transplant ineligible patients aged over 65 years a propensity score matched study |
| topic | older patients multiple myeloma relapsed or refractory daratumumab isatuximab propensity score matching analysis |
| url | https://www.mdpi.com/2038-8330/16/4/68 |
| work_keys_str_mv | AT satoshiyamasaki efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT michitoshihashiguchi efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT naoyoshidasakai efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT hirotojojima efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT koichiosaki efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT takashiokamura efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy AT yutakaimamura efficacyofanticd38monoclonalantibodiesforrelapsedorrefractorymultiplemyelomainstemcelltransplantineligiblepatientsagedover65yearsapropensityscorematchedstudy |