teclistamab 在既往暴露于 BCMA 靶向治疗的复发/难治性多发性骨髓瘤患者中的结局：来自美国多发性骨髓瘤免疫治疗联盟的多中心研究

Data describing outcomes of teclistamab in multiple myeloma patients with prior exposure to BCMA-directed therapy (BCMA-DT) are limited. The goal of this multicenter retrospective analysis was to report the efficacy and safety of standard-of-care teclistamab in patients with prior BCMA-DT.

A total of 385 patients were included, of whom 193 (50%) had received prior BCMA-DT, including 47 (24%) patients with prior antibody-drug conjugate (ADC)-only, 99 (51%) with chimeric antigen receptor T-cell therapy (CAR T)-only, 36 (19%) with both ADC and CAR T, 6 (3%) with bispecific antibody-only, and 5 (3%) with other combinations.

Most safety parameters between cohorts were comparable. The prior BCMA-DT cohort had a lower overall response rate (ORR: 48. 7% versus 61. 5%; p = 0. 012), and median progression-free survival (PFS: 4. 6 versus 8. 2 months; p = 0. 017) compared to the cohort without prior BCMA-DT.

However, in multivariable analysis, despite a clear trend, ultimately receipt of a prior BCMA-DT was not independently associated with ORR or PFS (p = 0. 057 and p = 0. 1, respectively). No significant differences in PFS were noted when stratifying patients by number of prior BCMA-DTs, types of all prior BCMA-DTs received, type of most recent prior BCMA-DT, or depth of response to most recent BCMA-DT. Using the maximally selected rank statistics method, the optimal cut-off for time from the last BCMA-DT exposure to teclistamab initiation was identified as 8.

7 months. Patients with >8. 7 months between their last exposure to prior BCMA-DT and teclistamab initiation had a significantly improved median PFS with teclistamab (8. 1 months, 95% CI: 4. 6-11. 7) compared to patients with <8. 7 months (2. 5 months, 95% CI: 1. 1-5. 7), p = 0. 001. Altogether, our findings support the use of teclistamab as a viable treatment option in patients previously exposed to BCMA-DT.