The changing spectrum of infection with BCMA and GPRC5D targeting bispecific antibody (bsAb) therapy in patients with relapsed refractory multiple myeloma. Haematologica 2024 Mar 01;109(3):906-914
Date
08/30/2023Pubmed ID
37646658Pubmed Central ID
PMC10905074DOI
10.3324/haematol.2023.283590Scopus ID
2-s2.0-85178101970 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
There is a paucity of granular data on infection risk with B-cell maturation antigen (BMCA) and GPRC5D bispecific antibodies (bsAb) in relapsed/refractory multiple myeloma (RRMM). The aim of our multi-institutional study was to characterize the incidence, etiologies, and risk factors of infections from the start of therapy to the last follow-up or 90 days after study exit. A total of 66 patients received BCMA bsAb monotherapy, 15 GPRC5D bsAb monotherapy, and 15 GPRC5D bsAb combination therapy with daratumumab and/or pomalidomide. While the infection rate per 100 days was 0.57 for BCMA bsAb, it was 0.62 for GPRC5D bsAb combination and 0.13 for GPRC5D bsAb monotherapy; P=0.05. The proportion of infections that were grade ≥3 was higher in the BCMA bsAb group compared to the GPRC5D groups (58% vs. 36%; P=0.04). Grade 5 events were observed in 8% (n=8) of the patients, all treated with BCMA bsAb. The 9 month cumulative incidence of any grade of infection was similar in the BCMA and GPRC5D-combination groups (57% and 62%) and significantly higher than in the GPRC5D-mono group (16%); P=0.012. The cumulative incidence of grade ≥3 infections was highest in the BCMA group reaching 54% at 18 months; P=0.06. Multivariate analysis showed that BCMA bsAb therapy or GPRC5D combination therapy, history of previous infections, baseline lymphopenia, and baseline hypogammaglobulinemia were significantly associated with a higher risk of grade ≥3 infections. Our results indicate that BCMA bsAb and GPRC5D-combination therapies in RRMM are associated with higher cumulative incidence of infection and grade ≥3 infection compared to GPRC5D bsAb mono.
Author List
Hammons L, Szabo A, Janardan A, Bhatlapenumarthi V, Annyapu E, Dhakal B, Al Hadidi S, Radhakrishnan SV, Narra R, Bhutani D, Thanendrarajan S, Janz S, Zangari M, Lentzsch S, Van Rhee F, Crescencio JCR, D'Souza A, Chakraborty R, Mohan M, Schinke CAuthors
Vineel Bhatlapenumarthi MD Assistant Professor in the Medicine department at Medical College of WisconsinAnita D'Souza MD Professor in the Medicine department at Medical College of Wisconsin
Binod Dhakal MD Associate Professor in the Medicine department at Medical College of Wisconsin
Siegfried Janz MD Professor in the Medicine department at Medical College of Wisconsin
Ravi Kishore Narra MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Sabarinath Venniyil Radhakrishnan MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Data Science Institute department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Antibodies, BispecificB-Cell Maturation Antigen
Combined Modality Therapy
Humans
Multiple Myeloma
Neoplasms, Plasma Cell
Receptors, G-Protein-Coupled
