Teclistamab for patients with heavily pretreated relapsed/refractory multiple myeloma and renal impairment

Teclistamab for patients with heavily pretreated relapsed/refractory multiple myeloma and renal impairment

Abstract: Outcomes of bispecific antibodies in patients with renal impairment (RI) are not well characterized, given the exclusion of these patients from clinical trials. Herein, we evaluated patients with relapsed/refractory multiple myeloma and RI treated with standard-of-care teclistamab. RI was...

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Main Authors: Danai Dima, Aimaz Afrough, Utkarsh Goel, Ariel F. Grajales-Cruz, Jack Khouri, Kelley Julian, Oren Pasvolsky, Rahul Banerjee, Beatrice Razzo, Christopher J. Ferreri, Mariola A. Vazquez-Martinez, James A. Davis, Aishwarya Sannareddy, Omar Castaneda, Shahzad Raza, Andrew J. Portuguese, Mahmoud R. Gaballa, Masooma S. Rana, Alex Lieberman-Cribbin, Shaun DeJarnette, Rebecca Gonzalez, Anna Chen, Megan M. Herr, Lekha Mikkilineni, Hitomi Hosoya, Evguenia Ouchveridze, Gurbakhash Kaur, Adriana Rossi, Leyla Shune, Faiz Anwer, Yi Lin, Shambavi Richard, Douglas W. Sborov, Rachid C. Baz, Alfred L. Garfall, Hans C. Lee, Larry D. Anderson, Jr., Andrew J. Cowan, Krina K. Patel, Peter M. Voorhees, Surbhi Sidana, Doris K. Hansen, Shebli Atrash, Sandra P. Susanibar-Adaniya
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952925002113
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Summary:Abstract: Outcomes of bispecific antibodies in patients with renal impairment (RI) are not well characterized, given the exclusion of these patients from clinical trials. Herein, we evaluated patients with relapsed/refractory multiple myeloma and RI treated with standard-of-care teclistamab. RI was defined as creatinine clearance (CrCl) <40 mL/min. CrCl <30 mL/min or dialysis dependence was defined as severe RI. Of the 384 included patients, 81 (21%) had RI, including 45 (18%) with severe RI, and 18 (5%) on dialysis. Patients with RI were more likely to be older (median age, 71 vs 67 years; P = .002) and have a higher median number of previous lines of therapy (7 vs 6; P = .04). Rates and severity of cytokine release syndrome (51% vs 59%; grade ≥3: 1.2% vs 1%) and immune effector cell–associated neurotoxicity syndrome (16% vs 13%; grade ≥3: 2.5% vs 2.6%) were similar in patients with and without RI, respectively. Patients with RI had higher baseline and day 30 post-teclistamab grade ≥3 anemia and grade ≥3 thrombocytopenia. Renal function did not worsen after teclistamab initiation in most patients with RI outside of the context of disease progression. Overall response rate (52% vs 56%; P = .61) and survival outcomes (median progression-free survival, 4.6 vs 6.5 months; P = .62) were comparable in patients with and without RI, respectively, after a median follow-up of 9.9 months. No differences in overall survival or non-relapse mortality were noted. Our findings suggest that treatment with teclistamab is feasible in patients with RI, including those on dialysis, with a similar safety and efficacy profile to patients without RI.
ISSN:2473-9529

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