Posted: Tuesday, July 18, 2023
A notable risk of infection has been associated with bispecific antibody therapy targeting B-cell maturation antigen (BCMA) and G protein–coupled receptor family C group 5 member D (GPRC5D) in patients with relapsed or refractory multiple myeloma, according to research presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8019). The study’s results were presented by Meera Mohan, MD, FACP, of the Medical College of Wisconsin, Milwaukee, and colleagues.
The study focused on 56 patients who received treatment with a bispecific antibody therapy targeting BCMA, 15 patients who received a GPRC5D bispecific antibody therapy combination with a CD38 monoclonal antibody with or without an immunomodulatory agent (GPRC5D combination), and 15 patients who received a bispecific antibody therapy targeting GPRC5D (GPRC5D monotherapy).
The authors reported that patients treated with BCMA incurred 89 total infections, patients treated with the GPRC5D combination therapy had 24 infections, and patients treated with the GPRC5D monotherapy had 4 infections. Of note, patients in the BCMA group exhibited a higher incidence of high-grade infections (≥ grade 3) compared with patients in the GPRC5D groups (P = .01). Furthermore, grade 5 events were reported only in patients treated with the BCMA bispecific antibody therapy (8% of all patients). At the 9-month follow-up, according to Dr. Mohan, the 9-month cumulative incidence of all-grade infections was similar between the BCMA and GPRC5D combination groups (57% and 62%)—a higher rate than in patients given GPRC5D monotherapy (16%, P = .012). Similarly, at 18 months, the cumulative incidence of grade 3 infections was highest among patients treated with the BCMA bispecific antibody therapy (P = .06).
Bacterial infections were most common for patients in the BCMA group (56%), followed by viral (37%) and fungal (7%) infections. In the GPRC5D monotherapy group, bacterial infections accounted for 46% of cases, followed by viral infections at 43% and fungal infections at 11%.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.