Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma
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.
Authors
- Heather Jolie Landau (ORCID: https://orcid.org/0000-0002-3152-1189)
- Benjamin Adegbite (ORCID: https://orcid.org/0000-0002-2070-7965)
- Kylee H. Maclachlan (ORCID: https://orcid.org/0000-0001-7873-4854)
- Hamza Hashmi (ORCID: https://orcid.org/0000-0002-4129-5867)
- Issam S. Hamadeh (ORCID: https://orcid.org/0000-0001-6628-0795)
- Saad Z. Usmani (ORCID: https://orcid.org/0000-0002-5484-8731)
- Tala Shekarkhand (ORCID: https://orcid.org/0000-0002-1404-4771)
- Malin L. Hultcrantz (ORCID: https://orcid.org/0000-0002-9045-6495)
- Gunjan L. Shah (ORCID: https://orcid.org/0000-0002-9977-0456)
- Kevin C. Miller (ORCID: https://orcid.org/0000-0002-5534-5570)
- Urvi Ashok Shah (ORCID: https://orcid.org/0000-0001-8419-1091)
- Alexander M. Lesokhin (ORCID: https://orcid.org/0000-0001-9321-702X)
- Michael Scordo (ORCID: https://orcid.org/0000-0002-9484-0240)
- Eric Matthew Jurgens (ORCID: https://orcid.org/0000-0001-8280-2581)
- Hani Hassoun (ORCID: https://orcid.org/0000-0002-2036-1749)
- Sham Mailankody (ORCID: https://orcid.org/0000-0002-2815-9561)
- Neha Korde (ORCID: https://orcid.org/0000-0002-5538-4318)
- Sridevi Rajeeve (ORCID: https://orcid.org/0000-0002-3458-824X)
- Sergio A. Giralt (ORCID: https://orcid.org/0000-0003-1944-5053)
- David Nemirovsky (ORCID: https://orcid.org/0009-0007-6971-1408)
- Andriy Derkach (ORCID: https://orcid.org/0000-0003-2178-8493)
- Carlyn Rose C. Tan (ORCID: https://orcid.org/0000-0001-7922-2594)
- Ross Firestone (ORCID: https://orcid.org/0000-0002-2945-9320)
Institutions
- Mount Sinai Hospital (US)
- Memorial Sloan Kettering Cancer Center (US)
Publication Details
- Journal
- Blood Advances
- Published
- 2025-05-02
- DOI
- https://doi.org/10.1182/bloodadvances.2025015973
- Citations
- 6
- Primary Topic
- Multiple Myeloma Research and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 10.62
Funders
- Amgen
- Bristol-Myers Squibb
- Pfizer
- GlaxoSmithKline
- Sanofi
- Gilead Sciences
- Celgene
- Memorial Sloan-Kettering Cancer Center
- Array BioPharma
- SkylineDx
- Omeros Corporation
- Seagen
- Springworks Therapeutics
- Genentech
- Pharmacyclics