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

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.

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Publication Details

Journal
Blood Advances
Published
2025-04-08
DOI
https://doi.org/10.1182/bloodadvances.2025016059
Citations
4
Primary Topic
Multiple Myeloma Research and Treatments
Type
article
Field-Weighted Citation Impact
7.08

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article

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

Jack Khouri, Rebecca M. Gonzalez, Mahmoud Gaballa, Sandra P. Susanibar-Adaniya et al.
4 citations
Blood Advances
Multiple Myeloma Research and Treatments
7.08
article

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

Jack Khouri, Rebecca M. Gonzalez, Mahmoud Gaballa, Sandra P. Susanibar-Adaniya, Beatrice M. Razzo, Faiz Anwer, Aimaz Afrough, Yi Lin, Surbhi Sidana, Rahul Kumar Banerjee, Danai Dima, Hitomi Hosoya, Andrew J. Portuguese, Shahzad Raza, Alfred L. Garfall, Lekha Mikkilineni, Larry D. Anderson, Leyla Shune, Utkarsh Goel, Shebli Atrash, Anna Chen, Omar Castañeda Puglianini, Shambavi Richard, Adriana Rossi, Hans Chulhee Lee, Aishwarya Sannareddy, Douglas W. Sborov, Gurbakhash Kaur, Krina K. Patel, Kelley Julian, Peter Michael Voorhees, Oren Pasvolsky, Mariola Alejandra Vazquez Martinez, Rachid Baz, Megan M. Herr, Masooma Rana, Christopher J. Ferreri, Alex Lieberman-Cribbin, Ariel Felipe Grajales-Cruz, James A. Davis, Andrew J. Cowan, Shaun DeJarnette, Doris K. Hansen
article en
4 citations

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.

Blood AdvancesVol. 9(14)
Roswell Park Comprehensive Cancer Center (US), Cleveland Clinic (US), Mayo Clinic (US), Texas Medical Center (US), The University of Texas MD Anderson Cancer Center (US), University of Kansas (US), Thomas Jefferson University (US), Medical University of South Carolina (US), Palo Alto University (US), University of Utah (US), Huntsman Cancer Institute (US), The University of Kansas Health System (US), WinnMed (US), University Medical Center (US), Moffitt Cancer Center (US), Cleveland Clinic Lerner College of Medicine (US), Fred Hutch Cancer Center (US), Southwestern Medical Center (US), Levine Cancer Institute (US), University Hospital and Clinics (US), University of Kansas Medical Center (US), Southwestern Medical Center (US), University of Charleston (US), University of Pennsylvania (US), The University of Texas Southwestern Medical Center (US), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
Pfizer
Good health and well-being
Openalex Percentile: Top 3%
Multiple Myeloma Research and Treatments
7.08
DOIOpen Access PDFOpenAlex
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