ArticleBlood cancer journal2024
Clinical features associated with poor response and early relapse following BCMA-directed therapies in multiple myeloma.
Article in Blood cancer journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Gene expression-based dissemination score predicts early spread and poor outcomes in multiple myeloma.Leukemia · 2026Article
- Bispecific CAR T and CAR NK cells in dual-threat immunotherapy: opportunities and challenges.Molecular biology reports · 2026Review
- Evaluation of Real-World Studies on Management of Relapsed Multiple Myeloma After BCMA-Directed Therapy Failure from U.S. Academic Centers and USMIRC.Current oncology (Toronto, Ont.) · 2026Article
- Whole-genome sequencing of cell-free DNA for assessment of minimal residual disease in high-risk smoldering multiple myeloma.HemaSphere · 2026Article
- Dose Delays and Treatment Interruptions Secondary to Ocular Toxicity From BCMA-Directed Antibody Drug Conjugate Therapy in Relapsed Multiple Myeloma.Clinical lymphoma, myeloma & leukemia · 2026Article
- Emerging precision medicine in multiple myeloma: clinical and preclinical landscape of T cell, natural killer cell, and macrophages engaging multi-specific antibodies.Frontiers in immunology · 2026Review
- Teclistamab for Relapsed or Refractory Multiple Myeloma: A Review of Efficacy, Safety, Resistance Mechanisms and Future Directions.Biologics : targets & therapy · 2026Review
- Real-world safety profile of T-cell engagers: evidence from multi-database analysis with CAR-T comparisons.Frontiers in immunology · 2026Article
- Current positioning and future development of belantamab mafodotin and other antibody-drug conjugates to treat multiple myeloma.Frontiers in oncology · 2026Review
- Plasma cell identity escape drives resistance to anti-BCMA T-cell-redirecting therapy in multiple myeloma.bioRxiv : the preprint server for biology · 2025Article
- The impact of extramedullary and paraskeletal plasmacytomas on treatment outcomes in multiple myeloma treated with teclistamab: U.S. Myeloma Immunotherapy Consortium real-world experience.Blood cancer journal · 2025Article
- TeclistamabHaematologica · 2025Article
- Therapeutic options for extramedullary involvement in multiple myeloma.Clinical and experimental medicine · 2025Review
- The Evolving Treatment Landscape for the Elderly Multiple Myeloma Patient: From Quad Regimens to T-Cell Engagers and CAR-T.Cancers · 2025Review
- Venetoclax-based treatment combinations in relapsed/refractory multiple myeloma: practice patterns and impact of secondary cytogenetic abnormalities on outcomes.Blood cancer journal · 2025Article
- A real-world experience of efficacy and safety of belantamab mafodotin in relapsed refractory multiple myeloma.Blood cancer journal · 2025Article
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
Three classes of BCMA-directed therapy (BDT) exist: antibody drug-conjugates (ADCs), CAR-T, and T-cell engagers (TCEs), each with distinct strengths and weaknesses. To aid clinicians in selecting between BDTs, we reviewed myeloma patients treated at Mayo Clinic with commercial or investigational BDT between 2018-2023. We identified 339 individuals (1-exposure = 297, 2-exposures = 38, 3-exposures = 4) who received 385 BDTs (ADC = 59, TCE = 134, CAR-T = 192), with median follow-up of 21-months. ADC recipients were older, with more lines of therapy (LOT), and penta-refractory disease. Compared to ADCs, CAR-T (aHR = 0.29, 95%CI = 0.20-0.43) and TCEs (aHR = 0.62, 95%CI = 0.43-0.91) had better progression-free survival (PFS) on analysis adjusted for age, the presence of extramedullary (EMD), penta-refractory disease, multi-hit high-risk cytogenetics, prior BDT, and the number of LOT in the preceding 1-year. Likewise, compared to ADCs, CAR-T (aHR = 0.28, 95%CI = 0.18-0.44) and TCEs (aHR = 0.60, 95%CI = 0.39-0.93) had superior overall survival. Prior BDT exposure negatively impacted all classes but was most striking in CAR-T, ORR 86% vs. 50% and median PFS 13-months vs. 3-months. Of relapses, 54% were extramedullary in nature, and a quarter of these cases had no history of EMD. CAR-T demonstrates superior efficacy and where feasible, should be the initial BDT. However, for patients with prior BDT or rapidly progressive disease, an alternative approach may be preferable.
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Registered trials
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