Frailty’s Impact on Outcomes in Older MM Patients Treated with Bispecifics | Nadine Abdallah, MD| #ASH24

My name is Nadine Abdallah. I'm a myeloma physician at Mayo Clinic in Rochester, Minnesota. I want to talk about one of my abstracts I'm presenting today, which is a frailty-based outcomes with bicep specific antibodies in older patients with multiple myeloma. We know that frailty is associated with increased risk of toxicities and inferior survival in patients with multiple myeloma with traditional therapies. We don't really know whether frailty is associated with inferior outcomes in patients being treated with bicep specific antibodies and CAR T therapies. In this study, we included 99 patients who received bicep specific antibodies, whether as standard of care or as part of a clinical trial, and we compared the outcomes of frail versus non-frail patients. We used a simplified frailty index to define frailty, which is based on age, performance status, and comorbidities. We found, which is consistent to what we found in CAR T, that frail patients and non-frail patients have similar efficacy, responses, progression-free survival, and overall survival. The follow-up was short, but the one-year overall survival was similar. We also looked at the rate of infections and the rate of cytopenias between the two groups, and we also found similar outcomes. When we compared the patients with poor performance status versus those with better performance status using the ECoG performance status score, we did find that patients with ECoG performance status of two or more had inferior outcomes. The comorbidity part of the frailty index, however, did not affect the outcomes. This data is actually reassuring and very encouraging, and it really tells us that older patients do benefit from those treatments. Even frail patients do benefit from those treatments. The outcomes are not inferior, and we should really be more comfortable using them. This is real-world data that focuses on all patients. Although we did include patients on clinical trials, we also had patients that extended care therapy, and those patients are not included in the regular clinical trials due to the inclusion criteria, which are very restricted.