The Role of Bispecific Antibodies in Relapsed Refractory Multiple Myeloma: A Systematic Review.
Razwana KhanamOmer S AshrufSyed Hamza Bin WaqarZunairah ShahSaba BatoolRameesha MehreenPranali PachikaZinath RoksanaMohammad Ebad Ur RehmanFaiz AnwarPublished in: Antibodies (Basel, Switzerland) (2023)
Multiple myeloma is a heterogeneous clonal malignant plasma cell disorder, which remains incurable despite the therapeutic armamentarium's evolution. Bispecific antibodies (BsAbs) can bind simultaneously to the CD3 T-cell receptor and tumor antigen of myeloma cells, causing cell lysis. This systematic review of phase I/II/III clinical trials aimed to analyze the efficacy and safety of BsAbs in relapsed refractory multiple myeloma (RRMM). A thorough literature search was performed using PubMed, Cochrane Library, EMBASE, and major conference abstracts. A total of 18 phase I/II/III studies, including 1283 patients, met the inclusion criteria. Among the B-cell maturation antigen (BCMA)-targeting agents across 13 studies, the overall response rate (ORR) ranged between 25% and 100%, with complete response/stringent complete response (CR/sCR) between 7 and 38%, very good partial response (VGPR) between 5 and 92%, and partial response (PR) between 5 and 14%. Among the non-BCMA-targeting agents across five studies, the ORR ranged between 60 and 100%, with CR/sCR seen in 19-63%, and VGPR in 21-65%. The common adverse events were cytokine release syndrome (17-82%), anemia (5-52%), neutropenia (12-75%), and thrombocytopenia (14-42%). BsAbs have shown promising efficacy against RRMM cohorts with a good safety profile. Upcoming phase II/III trials are much awaited, along with the study of other agents in concert with BsAbs to gauge response.
Keyphrases
- multiple myeloma
- systematic review
- clinical trial
- phase ii
- end stage renal disease
- chronic kidney disease
- acute lymphoblastic leukemia
- diffuse large b cell lymphoma
- acute myeloid leukemia
- single cell
- newly diagnosed
- induced apoptosis
- prognostic factors
- stem cells
- cancer therapy
- ejection fraction
- meta analyses
- signaling pathway
- randomized controlled trial
- drug delivery
- case control
- study protocol
- cell cycle arrest
- case report
- oxidative stress
- bone marrow
- patient reported outcomes
- phase iii