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多发性骨髓瘤免疫治疗序贯的真实世界证据:既往 GPRC5D 靶向治疗后 BCMA 靶向双特异性抗体可带来持久缓解

英文原题:Real-World Evidence of Immunotherapy Sequencing in Multiple Myeloma: Durable Responses With BCMA-Targeting Bispecific Antibodies Following Prior GPRC5D-Targeting Therapy.

PubMed 2026/06/14(内容时间) Clin Lymphoma Myeloma Leuk Q1 · IF 4.1(JCR 2025)

研究概要

靶向BCMA的双特异性抗体为经靶向GPRC5D的双特异性抗体治疗后进展的患者提供了一种有效且耐受性良好的治疗选择,支持该序贯方案作为一种有前景策略的可行性。

中文摘要

背景:靶向B细胞成熟抗原(BCMA)或G蛋白偶联受体C类第5组成员D(GPRC5D)的双特异性抗体(BsAb)和CAR-T 细胞疗法等T细胞重定向治疗(TCRT),已在复发/难治性多发性骨髓瘤(RRMM)患者中显示显著疗效。然而,复发仍很常见,因此需要优化TCRT的序贯治疗策略。 患者与方法:这项多中心回顾性研究评估了RRMM患者既往接受GPRC5D靶向BsAb治疗后,再接受BCMA靶向BsAb治疗的安全性和疗效。 结果:研究共纳入26例患者,中位随访20.35个月。总体缓解率为58%,中位无进展生存期(PFS)为6.8个月,中位总生存期为15.9个月。应答者的PFS显著长于未应答者(未达到 vs. 3.5个月,P<.001)。安全性特征与既往BCMA靶向BsAb研究一致:50%的患者发生细胞因子释放综合征,但均未达到3级及以上;38%的患者发生3级及以上感染。 结论:对于既往接受GPRC5D靶向BsAb后出现疾病进展的患者,BCMA靶向BsAb提供了一种有效且耐受性良好的治疗选择,支持这一序贯治疗方案具有可行性,并可能成为一种有前景的策略。

展开英文摘要原文

BACKGROUND: T-cell-redirecting therapies (TCRTs), including bispecific antibodies (BsAbs) and chimeric antigen receptor-T-cell therapy targeting B-cell maturation antigen (BCMA) or G-protein-coupled receptor class C group 5 member D (GPRC5D), have demonstrated significant efficacy in patients with relapsed/refractory multiple myeloma (RRMM). However, relapse remains common, highlighting the need for optimized TCRT sequencing strategies. PATIENTS AND METHODS: This retrospective multicenter study evaluated the safety and efficacy of BCMA-targeting BsAbs following prior treatment with GPRC5D-targeting BsAbs in RRMM patients. RESULTS: A total of 26 patients were included, with a median follow-up of 20.35 months. The overall response rate was 58%, with a median progression-free survival (PFS) of 6.8 months and a median overall survival of 15.9 months. Responders demonstrated significantly longer PFS compared to nonresponders (not reached vs. 3.5 months, P < .001). The safety profile remained consistent with previous BCMA-targeting BsAbs, with cytokine release syndrome occurring in 50% of patients--none of whom experienced grade ≥ 3 events--and 38% developing grade ≥ 3 infections. CONCLUSION: BCMA-targeting BsAbs offer an effective and well-tolerated treatment option for patients who have progressed after GPRC5D-targeting BsAbs, supporting the feasibility of this sequential approach as a promising strategy.

论文信息

作者
Cazaubiel T、Touzeau C、Vincent L、Belhadj K、Karlin L、Manier S、Perrot A、Vekemans MC
单位
Department of Hematology, University Hospital of Bordeaux, Pessac, France; Cancer Research Center of Toulouse, INSERM, Toulouse, France. Electronic address: titouan.cazaubiel@inserm.fr.France
文献类型
多中心研究
期刊
Clinical lymphoma, myeloma & leukemia2026 Aug
原文标识
PubMed 42401497 · DOI 10.1016/j.clml.2026.06.005