Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34023
Title: Infections following bispecific antibodies in myeloma: a systematic review and meta-analysis.
Austin Authors: Reynolds, Gemma;Cliff, Edward R Scheffer;Mohyuddin, Ghulam Rehman;Popat, Rakesh;Midha, Shonali;Liet Hing, Melissa Ng;Harrison, Simon J;Kesselheim, Aaron S;Teh, Benjamin W
Affiliation: National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Program on Regulation, Therapeutics and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT.
NIHR UCLH Clinical Research Facility, University College London Hospitals, NHS Foundation Trust, London, United Kingdom.
Division of Myeloma, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia.;Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
Program on Regulation, Therapeutics and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
Infectious Diseases
Issue Date: 10-Oct-2023
Publication information: Blood Advances 2023-10-10; 7(19)
Abstract: Bispecific antibodies, a novel immunotherapy with promising efficacy against multiple myeloma, form immune synapses between T-cell surface marker CD3 and malignant cell markers, including B-cell maturation antigen (BCMA), FcRH5, and G protein-coupled receptor GPRC5D. These bispecific antibodies so effectively deplete plasma cells (and to some extent T-cells) that patients are at increased risk of developing infections. A systematic review and meta-analysis of infections in published studies of patients with myeloma treated with bispecific antibodies was conducted to better characterize the infection risks. A literature search used MEDLINE, EMBASE, and Cochrane to identify relevant studies between inception and February 10, 2023, including major conference presentations. Phase 1b-3 clinical trials and observational studies were included. Sixteen clinical trials comprising 1666 patients were included. Median follow-up was 7.6 months and 38% of the cohort had penta-drug refractory disease. Pooled prevalence of all-grade infections was 56%, whereas the prevalence of grade ≥3 infections was 24%. Patients who were treated with BCMA-targeted bispecifics had significantly higher rates of grade ≥3 infections than non-BCMA bispecifics (25% vs 20%). Similarly, patients treated with bispecifics in combination with other agents had significantly higher rate of all-grade infection than those receiving monotherapy (71% vs 52%). In observational studies (n = 293), excluded from the primary analysis to ensure no overlap with patients in clinical trials, several infections classically associated with T-cell depletion were identified. This systematic review identifies BCMA-targeted bispecifics and bispecific combination therapy as having higher infection risk, requiring vigilant infection screening and prophylaxis strategies.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34023
DOI: 10.1182/bloodadvances.2023010539
ORCID: 0000-0002-9561-3592
0000-0001-5977-907X
0000-0001-6464-783X
0000-0003-4555-6582
0000-0002-8867-2666
0000-0003-0213-5470
Journal: Blood Advances
Start page: 5898
End page: 5903
PubMed URL: 37467036
ISSN: 2473-9537
Type: Journal Article
Subjects: Multiple Myeloma/drug therapy
Multiple Myeloma/pathology
Antibodies, Bispecific/adverse effects
B-Cell Maturation Antigen/therapeutic use
Appears in Collections:Journal articles

Show full item record

Page view(s)

8
checked on May 30, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.