Real-world outcomes with BCMA- and GPRC5D-targeting bispecific antibodies in plasma cell leukemia.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Gaballa Mahmoud R, Julian Kelley, Afrough Aimaz, Hansen Doris K, Goel Utkarsh, De Menezes Silva Corraes Andre, Dima Danai, Rana Masooma, Hosoya Hitomi, Mikkilineni Lekha, Fogel Lindsay, Raza Shahzad, Banerjee Rahul, Zanwar Saurabh S, Pasvolsky Oren, Sannareddy Aishwarya, Borogovac Azra, Davis James, Green Kimberly, Biran Noa, Zolotov Eli, Herr Megan, Shune Leyla, Ouchveridze Evguenia, DeJarnette Shaun, Atrash Shebli, Ferreri Christopher, Richards Tiffany, Abid Muhammad Bilal, Bal Susan, Ali Hossam M, Ye Jing Christine, Richard Shambavi, Kaur Gurbakhash, Shain Kenneth, Castaneda-Puglianini Omar, Harada Ken, De Avila Gabriel, Rossi Adriana, Hassan Hamza, Anderson Larry D, Voorhees Peter M, Khouri Jack, Sidana Surbhi, Portuguese Andrew J, Janakiram Murali, Lee Hans C, Lin Yi, Grajales-Cruz Ariel, Patel Krina K, Sborov Douglas W
Аннотация
Patients with plasma cell leukemia (PCL) are generally excluded from pivotal T-cell-redirecting bispecific antibody (BsAb) trials. We evaluated real-world outcomes in a multicenter retrospective study of 122 patients with primary or secondary PCL across 15 academic centers, categorized as active (≥5% circulating plasma cells within 30 days before BsAb initiation) or historical. Patients received teclistamab (37%), elranatamab (11%), talquetamab as a line of therapy (Tal LOT, 42%), or talquetamab as bridging to CAR T-cell therapy (Tal Bridge, 11%). Cytokine release syndrome was grade 1 to 2 in 56% and grade 3 to 4 in 4% of patients, whereas neurotoxicity was grade 1 to 2 in 16% and grade 3 to 4 in 5% of patients. The overall response rate was 55%, including 61% with Tal LOT, 58% with Tal Bridge, 46% with elranatamab, and 33% with teclistamab. With a median follow-up of 8.3 months, talquetamab demonstrated superior survival. Tal LOT showed a median progression-free survival (mPFS) of 5.5 months and a median overall survival (mOS) of 11.5 months, and both were unreached in the Tal Bridge cohort. In contrast, teclistamab and elranatamab showed a mPFS values of 1.2 and 1.6 months and mOS values of 8.1 and 3.6 months, respectively (P = .007, P = .023). In active PCL, Tal LOT achieved mPFS/mOS of 6.9/12.2 months vs 0.7/1.4 months with teclistamab and 1.0/3.1 months with elranatamab, respectively (P< .001, P = .002). Multivariable analysis associated active PCL with worse survival and Tal LOT with improved outcomes. BsAbs were well tolerated in PCL, with talquetamab showing superior outcomes compared with B-cell maturation antigen-directed BsAbs.