Teclistamab, a BCMA-directed bispecific antibody, received regulatory approval for relapsed/refractory multiple myeloma (RRMM) based on the MajesTEC-1 study. Despite the fact that myeloma is primarily a cancer of elderly adults, only 15% of MajesTEC-1 participants (n = 24) were ≥75 years old. In this multicenter retrospective study, we report real-world outcomes of a large cohort of older RRMM patients treated with teclistamab. Of 385 analyzed patients, 83 (22%) were in the older group (age ≥75) and 302 (78%) in the younger group (age <75). Compared to the younger group, the older group had less adverse baseline disease characteristics, including a lower incidence of high-risk cytogenetics (44.6% vs. 57.9%, p = 0.03) and extramedullary disease (22% vs. 40%, p = 0.02). There were no significant differences in rates of any-grade CRS (52% vs. 59%, p = 0.27), any-grade ICANS (19% vs. 13%, p = 0.12), and overall response rate (62% vs. 53%, p = 0.17) between the older and younger groups. In multivariable analysis, age was not significantly associated with survival outcomes. Our findings suggest that teclistamab is safe and efficacious in well-selected patients ≥75 years old, and advanced age alone should not preclude teclistamab administration.
特立妥单抗（Teclistamab）作为一种BCMA靶向双特异性抗体，基于MajesTEC-1研究获得了治疗复发/难治性多发性骨髓瘤（RRMM）的监管批准。尽管骨髓瘤主要是一种老年癌症，但MajesTEC-1研究中仅有15%的参与者（n=24）年龄≥75岁。在这项多中心回顾性研究中，我们报告了大量接受特立妥单抗治疗的老年RRMM患者的真实世界疗效。在385例分析患者中，83例（22%）属于老年组（年龄≥75岁），302例（78%）属于较年轻组（年龄<75岁）。与较年轻组相比，老年组患者基线疾病不良特征较少，包括高危细胞遗传学发生率较低（44.6% vs. 57.9%，p=0.03）和髓外病变发生率较低（22% vs. 40%，p=0.02）。两组间任何级别的细胞因子释放综合征（52% vs. 59%，p=0.27）、任何级别的免疫效应细胞相关神经毒性综合征（19% vs. 13%，p=0.12）以及总体缓解率（62% vs. 53%，p=0.17）均无显著差异。多变量分析显示，年龄与生存结局无显著相关性。我们的研究结果表明，经过充分筛选的≥75岁患者使用特立妥单抗安全有效，高龄本身不应成为使用特立妥单抗的禁忌。
肿瘤(癌症)患者之家