Real-world outcomes of patients with relapsed refractory multiple myeloma treated with commercial bispecific T-cell engager antibodies: a single center experience

T-cell engagers (TCE) have altered the therapeutic landscape for relapsed/refractory multiple myeloma (MM). Yet, patients in the real-world may have been ineligible for pivotal studies and TCEs are not widely accessible. A single-center retrospective study of 79 patients treated with teclistamab, talquetamab, or elranatamab was conducted. Forty-six percent had high-risk cytogenetics, 42% had EMD, and 44% had prior BCMA-exposure. ORR was similar to trials, 64%. PFS and OS were 4.44 and 13.3 months, respectively - both substantially shorter than clinical trials. On univariate analysis, having Medicare supplemental, secondary insurance, or advantage plans was associated with improved OS, but this did not persist on multivariate. Income below the NJ median and lack of accompaniment trended toward inferior OS. Achieving less than a PR to the last line was associated with inferior PFS/OS. Prospective studies should evaluate earlier utilization of TCEs and increasing early access for patients with low income.