Real-world outcomes of patients with multiple myeloma treated with T-cell engagers compared to those treated on clinical trials.

• DOI: 10.1200/jco.2025.43.16_suppl.e19519
• Publication Date: 2025-05-28T17:43:48Z
• Authors: Lindsay Fogel; Jaeil Ahn; Adolfo Aleman; Fideliza Perez-Manon; Natali Arias-Orozco; Kathleen Builes; Kiara Londono; Gabriella Monteleone; Harsh Parmar; Pooja Phull; David H. Vesole; David Samuel DiCa...; Andrew Ip; Noa Biran

e19519 Background: T-cell engagers (TCE) have altered the therapeutic landscape, demonstrating response rates of 60-70% for patients with relapsed/refractory multiple myeloma (RRMM). Median progression free survival (PFS) among BCMA x CD3 TCEs teclistamab (Tec) and elranatamab (Elran) GPRC5D TCE talquetamab (Talq) ranges between 10 to 22 months. Yet, many RRMM treated in practice would been ineligible clinical trials due stringent inclusion criteria. Methods: A single-center retrospective chart review consecutive commercial Tec, Talq, or Elran 1/1/23-10/31/24 was performed. Baseline patient disease characteristics, prior treatments, toxicities TCEs, outcomes were extracted from electronic records. Descriptive statistics, univariate (UV) multivariate (MV) analyses Results: total 79 who received at least 1 dose Tec (N=29, 37%), Talq (N=40, 51%), (N=10, 13%) evaluated. Most (89.8%) MajesTEC-1, MomenTAL-1, MagnetisMM-1 respectively exposure, cytopenias, renal dysfunction, comorbidities. Twenty-eight (36%) under-represented minorities (18% Black, 18% Hispanic). High risk cytogenetics present 63% 22% had del(17p). Twenty-nine (37%) extra-medullary (EMD). All triple class exposed 70% penta-class exposed. About half (44%) BCMA-exposed. The overall rate (ORR) 62%, mPFS 6.8 months, median (OS) 16.23 months all patients. Achieving PR better last line therapy before correlated improved ORR (p=0.018). Using MV analysis, EMD associated inferior OS (HR 2.24; p=0.039). Del(17p) PFS 2.29; p=0.029). VGPR as best showed a trend toward (9.6 mo vs 4.9 mo; p=0.12). type product not OS. Toxicity similar that seen trials, 73% experiencing CRS, 10% neurotoxicity, 46% infections. Conclusions: Our analysis RW data reveals safety but compared those on trials. Factors such EMD, an aggressive biology wherein are unable enroll delays screening slot allocation may potentially explain discrepant our study. Patients started following ≥PR ORR, implying benefit be greater low burden disease. absence differences efficacy amongst suggest specificity receptors is critical fitness.