The impact of extramedullary and paraskeletal plasmacytomas on treatment outcomes in multiple myeloma treated with teclistamab: U.S. Myeloma Immunotherapy Consortium real-world experience

Teclistamab, a bispecific antibody targeting B-cell maturation antigen (BCMA), is effective in relapsed or refractory multiple myeloma (RRMM), but its impact on patients with soft tissue plasmacytomas is unclear. We studied 385 RRMM patients treated with teclistamab at 13 U.S. centers through September 2023, with follow-up to April 2024. Soft tissue plasmacytomas were classified as true extramedullary disease (EMD; not contiguous with bone) or paraskeletal plasmacytomas (PSK; contiguous with bone). Patients with the simultaneous presence of both were classified as true-EMD, reflecting its adverse prognosis. Of those, 109 (28%) had true EMD, 33 (9%) had PSK, and 243 (63%) had no soft tissue plasmacytoma (No-STP). Median follow-up was 9.9 months. Overall response rates were 38% in true-EMD, 54.1% in PSK, and 62.4% in No-STP (p < 0.001). Median progression-free survival (PFS) was 1.4 months in true-EMD, 6.51 months in PSK, and 8.95 months in No-STP (p < 0.0001). Median overall survival (OS) was 9.54 months for true EMD, 13.1 months for PSK, and not reached in No-STP (p = 0.00012). In multivariable analysis, true-EMD was independently associated with inferior PFS and OS, while PSK showed numerically lower outcomes. These findings highlight the need for tailored strategies in patients with soft tissue plasmacytomas, particularly those with true-EMD.

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Journal
Blood Cancer Journal
Published
2025-11-28
DOI
https://doi.org/10.1038/s41408-025-01414-6
Primary Topic
Multiple Myeloma Research and Treatments
Type
article
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article

The impact of extramedullary and paraskeletal plasmacytomas on treatment outcomes in multiple myeloma treated with teclistamab: U.S. Myeloma Immunotherapy Consortium real-world experience

Jack Khouri, Mahmoud Gaballa, Sandra P. Susanibar-Adaniya, Beatrice M. Razzo et al.
Blood Cancer Journal
Multiple Myeloma Research and Treatments
article

The impact of extramedullary and paraskeletal plasmacytomas on treatment outcomes in multiple myeloma treated with teclistamab: U.S. Myeloma Immunotherapy Consortium real-world experience

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

Abstract

Teclistamab, a bispecific antibody targeting B-cell maturation antigen (BCMA), is effective in relapsed or refractory multiple myeloma (RRMM), but its impact on patients with soft tissue plasmacytomas is unclear. We studied 385 RRMM patients treated with teclistamab at 13 U.S. centers through September 2023, with follow-up to April 2024. Soft tissue plasmacytomas were classified as true extramedullary disease (EMD; not contiguous with bone) or paraskeletal plasmacytomas (PSK; contiguous with bone). Patients with the simultaneous presence of both were classified as true-EMD, reflecting its adverse prognosis. Of those, 109 (28%) had true EMD, 33 (9%) had PSK, and 243 (63%) had no soft tissue plasmacytoma (No-STP). Median follow-up was 9.9 months. Overall response rates were 38% in true-EMD, 54.1% in PSK, and 62.4% in No-STP (p < 0.001). Median progression-free survival (PFS) was 1.4 months in true-EMD, 6.51 months in PSK, and 8.95 months in No-STP (p < 0.0001). Median overall survival (OS) was 9.54 months for true EMD, 13.1 months for PSK, and not reached in No-STP (p = 0.00012). In multivariable analysis, true-EMD was independently associated with inferior PFS and OS, while PSK showed numerically lower outcomes. These findings highlight the need for tailored strategies in patients with soft tissue plasmacytomas, particularly those with true-EMD.

Blood Cancer JournalVol. 16(1)
Roswell Park Comprehensive Cancer 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), Duke University (US), Palo Alto University (US), University of Utah (US), Huntsman Cancer Institute (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), Mayo Clinic in Arizona (US), University of Pennsylvania (US), The University of Texas Southwestern Medical Center (US), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, Gilead Sciences, Alexion Pharmaceuticals, Celgene, Regeneron Pharmaceuticals, Prothena, Adaptive Biotechnologies, BeiGene, Genentech, Kite Pharma, Legend Biotech
Openalex Percentile: Top 51%
Multiple Myeloma Research and Treatments
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