Early mortality with bsAb therapy in RRMM: A real-world analysis

Results from a multicenter, retrospective, real-world analysis, evaluating early mortality in patients with relapsed/refractory multiple myeloma (RRMM) treated with commercial bispecific antibodies (bsAbs) (N = 441), were published in Blood Advances by Tan et al. Data from the International Myeloma Working Group Immunotherapy Database were evaluated to assess early mortality, defined as death within 12 months of therapy initiation (teclistamab, n = 234; elranatamab, n = 67; talquetamab, n = 140).

Key data: Early mortality occurred in 34% of patients, with a median time to death of 2.87 months; 71% of deaths occurred within the first 6 months of therapy. Progressive disease was the leading cause of early mortality (72%), followed by infection (13%). On multivariable analysis, baseline platelet count <50 × 10⁹/L before therapy initiation was associated with increased risk of early mortality (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.16–3.21; p = 0.02), while experiencing a partial response or better was associated with reduced risk (HR, 0.22; 95% CI, 0.12–0.40; p < 0.001).

Key learning: Early mortality remains a challenge in patients receiving bsAb therapy for RRMM, and is predominantly driven by progressive disease. These data highlight the importance of optimizing early disease control and supportive care strategies in this setting.