Outcomes of Penta-Refractory Multiple Myeloma Patients Treated with or without BCMA-Directed Therapy

Shebli Atrash, Aytaj Mammadzadeh, Fulei Peng, Omar Alkharabsheh, Aimaz Afrough, Wei Cui, Zahra Mahmoudjafari, Al Ola Abdallah, Hamza Hashmi

Research output: Contribution to journalArticlepeer-review

Abstract

Despite advances in treatment, outcomes remain poor for patients with penta-relapsed refractory multiple myeloma (RRMM). In this retrospective analysis, we evaluated the survival outcomes of penta-RRMM patients treated with (BCMA)- directed therapy (BDT). We identified 78 patients with penta-RRMM. Median age was 65 years, 29 (37%) had R-ISS stage III disease, 63 (81%) had high-risk cytogenetics, and 45 (58%) had extra-medullary disease. Median LOT prior to penta-refractory state was 5 (3–12). Amongst penta-RRMM, 43 (55%) were treated with BDT, 35 (45%) were not treated with BDT. Type of BDT received included belantamab mafadotin 15 (35%), Chimeric Antigen Receptor T-cell therapy 9 (21%), BCMA monoclonal antibody 6 (14%), and Bispecific T-cell engager 2 (5%). Eleven (25%) patients received more than one BDT. No significant differences were identified between baseline characteristics for the two groups. Patients treated with a BDT had better median overall survival, 17 vs. 6 months, HR 0.3 p-value < 0.001. Poor performance status, white race, and high-risk cytogenetics were associated with worse outcomes, whereas using a BDT was associated with better outcomes. Patients with penta-refractory MM have poor outcomes. Our retrospective analysis showed a significant survival benefit using BDT when compared to non-BDT for patients with penta-RRMM.

Original languageEnglish (US)
Article number2891
JournalCancers
Volume15
Issue number11
DOIs
StatePublished - Jun 2023

Keywords

  • BCMA-directed therapy
  • penta-class refractory myeloma
  • plasma cell disorders
  • relapsed multiple myeloma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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