Synapse - Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma

Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma Journal Article

Authors:	Adegbite, B.; Tan, C. R.; Shekarkhand, T.; Firestone, R. S.; Jurgens, E. M.; Miller, K.; Lesokhin, A. M.; Shah, G. L.; Korde, N.; Rajeeve, S.; Landau, H. J.; Scordo, M.; Hassoun, H.; Maclachlan, K. H.; Shah, U. A.; Hultcrantz, M.; Hamadeh, I. S.; Derkach, A.; Nemirovsky, D.; Giralt, S. A.; Mailankody, S.; Usmani, S. Z.; Hashmi, H.
Article Title:	Outcomes in frail patients receiving BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma
Abstract:	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.
Keywords:	bortezomib
Journal Title:	Blood Advances
Volume:	9
Issue:	15
ISSN:	2473-9529
Publisher:	American Society of Hematology
Publication status:	Published
Date Published:	2025-08-12
Online Publication Date:	2025-05-02
Start Page:	4016
End Page:	4022
Language:	English
ACCESSION:	WOS:001548314800002
DOI:	10.1182/bloodadvances.2025015973
PROVIDER:	wos
PMCID:	PMC12345270
PUBMED:	40315372
Notes:	Article -- MSK corresponding authors are Hamza Hashmi and Carlyn Tan -- Source: Wos