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<p>In multiple myeloma, functional high risk (FHR) is a predictor of poor outcomes. It is defined as M protein reduction to ≤ 50% of normal, suboptimal response (SR), or progressive disease (PD) within 12&#xa0;months (i.e., early PD). The clinical significance of anti-CD38 monoclonal antibody (MoAb) as second-line treatment for FHR myeloma remains unclear. We retrospectively investigated the efficacy of anti-CD38 MoAb as second-line treatment for FHR myeloma. We included 332 patients who were newly diagnosed with myeloma and received proteasome inhibitors and/or immunomodulatory drugs as first-line therapy. Their median age was 70&#xa0;years, and 29.4% were FHR. At a median follow-up of 48.5&#xa0;months, the overall survival (OS) in the FHR group was significantly shorter (hazard ratio [HR], 2.086; <i>P</i> &lt; 0.001). However, the OS in the SR without early-PD group was comparable to that in the non-FHR group (HR, 1.659; <i>P</i> = 0.330). The OS in patients with FHR who received anti-CD38 MoAb as second-line treatment was similar to that in the non-FHR group (HR, 1.157; <i>P</i> = 0.660). Anti-CD38 MoAb as second-line treatment improved the outcome in our patients with FHR although FHR predicted a poor prognosis.</p>

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Second-line anti-CD38 monoclonal antibody therapy mitigates the negative impact of functional high-risk status in myeloma patients

  • 期刊论文

  • 发表日期：

    2025年2月9日

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  • Kazuhito Suzuki,
  • Tadahiro Gunji,
  • Riku Nagao,
  • Masaharu Kawashima,
  • Hideki Uryu,
  • Mamiko Momoki,
  • Hiroto Ishii,
  • Ryoko Fukushima,
  • Mitsuji Katori,
  • Hiroki Yokoyama,
  • Atsushi Katsube,
  • Takeshi Saito,
  • Kaichi Nishiwaki,
  • Shingo Yano

摘要

In multiple myeloma, functional high risk (FHR) is a predictor of poor outcomes. It is defined as M protein reduction to ≤ 50% of normal, suboptimal response (SR), or progressive disease (PD) within 12 months (i.e., early PD). The clinical significance of anti-CD38 monoclonal antibody (MoAb) as second-line treatment for FHR myeloma remains unclear. We retrospectively investigated the efficacy of anti-CD38 MoAb as second-line treatment for FHR myeloma. We included 332 patients who were newly diagnosed with myeloma and received proteasome inhibitors and/or immunomodulatory drugs as first-line therapy. Their median age was 70 years, and 29.4% were FHR. At a median follow-up of 48.5 months, the overall survival (OS) in the FHR group was significantly shorter (hazard ratio [HR], 2.086; P < 0.001). However, the OS in the SR without early-PD group was comparable to that in the non-FHR group (HR, 1.659; P = 0.330). The OS in patients with FHR who received anti-CD38 MoAb as second-line treatment was similar to that in the non-FHR group (HR, 1.157; P = 0.660). Anti-CD38 MoAb as second-line treatment improved the outcome in our patients with FHR although FHR predicted a poor prognosis.