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ASH 2024 | Outcomes of bispecific T-cell engager therapy for frail patients with R/R multiple myeloma
Hamza Hashmi, MD, Memorial Sloan Kettering Cancer Center, New York, NY, comments on a study investigating the outcomes of bispecific T-cell engager therapy in patients with relapsed/refractory (R/R) multiple myeloma who are considered frail. Dr Hashmi highlights that frail patients do not experience significantly higher toxicities or poorer outcomes, with no statistically significant difference in progression-free survival (PFS) and overall survival (OS) compared to non-frail patients. This study suggests that frail patients should be included in clinical trials, as they may benefit from therapies despite having a higher comorbidity burden. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI generated)
So in this particular abstract, we highlight the outcomes of patients who received bispecific antibody in the real-world experience who are considered to be frail. So we know that the median age for myeloma is around 69 years and many of the patients at the time of newly diagnosed myeloma or relapsed disease are elderly, have comorbidities and poor performance status. And many of these patients get excluded in clinical trials, and we don’t know about their outcomes from these trials...
So in this particular abstract, we highlight the outcomes of patients who received bispecific antibody in the real-world experience who are considered to be frail. So we know that the median age for myeloma is around 69 years and many of the patients at the time of newly diagnosed myeloma or relapsed disease are elderly, have comorbidities and poor performance status. And many of these patients get excluded in clinical trials, and we don’t know about their outcomes from these trials. And hence, we did a single-center study evaluating the outcomes in patients who are considered to be frail after receiving bispecific antibodies. So we looked at our single-center experience with 140 patients who received either teclistamab, elranatamab, or talquetamab, and evaluated both the safety and efficacy of these treatments for these patients. And what we learned in our analysis is that nearly 40% of our patient population was considered to be frail. These frail patients tend to be elderly. They had worse performance status and higher comorbidity burden. And we learned that these patients do not experience any significantly higher incidence of toxicities like CRS, ICANS, infections, or cytopenias. We also learned that while responses may be a little deeper in these patients who are considered to be frail, their progression-free survival and overall survival is not any statistically significantly different from patients who are considered to be non-frail. So essentially what we established now in our study with a single center experience is that frail patients do not experience any excessive toxicities and have efficacy benefits similar to the ones that are considered to be non-frail. And hence we should be less stringent with our eligibility criteria for clinical trials and include these patients in trials where they may be getting benefits from the therapies.
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