Session: 653. Multiple Myeloma: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, Adult, Elderly, Clinical Research, Plasma Cell Disorders, Diseases, Real-world evidence, Lymphoid Malignancies, Adverse Events, Technology and Procedures, Study Population, Human, Machine learning
Methods: Unselected patients with RRMM treated with bispecific antibodies and sex-matched controls comprising patients with smouldering myeloma (SMM) and Monoclonal Gammopathy of Undetermined Significance (MGUS) that had routine PET-CT scans were compared. Retrospective BC analyses were performed on whole-body CT components using Data Analysis Facility Suite (DAFS), a validated commercial software produced by Voronoi Health Analytics Inc. Each scan was manually checked by a clinician. This was part of the AUTOPILOT study, a collaboration between UCLH and the BiCyCLE team of St Mark’s Academic Institute and The National Bowel Hospital, London, United Kingdom. Comparison of characteristics was performed including between subgroups based on outcomes such as CRS and mortality. Kaplan Meier analysis was performed to determine progression-free survival by bispecific antibody type.
Results: 43 RRMM patients that had a median of 5 (1-12) prior lines of therapy and received GPRC5D/CD3 bispecific antibodies (25, 58%) or BCMA/CD3 bispecifics (18, 42%) were assessed with 43 controls (32 male (74%),11 female (26%)). The control population was slightly older [RRMM median age (range); 60 (49 - 73) years, controls 66 (31 - 83) years]. BC analyses demonstrated no significant difference in Body Mass Index (BMI), total skeletal muscle, lung volumes as well as visceral and subcutaneous adipose tissue volumes between RRMM and controls. However, RRMM patients had significantly higher total cortical (p= 0.009) and trabecular bone volumes (p=0.02).
CRS occurred in 30 patients (70%) and was Grade 2 or less. There was no statistically significant difference between risk of CRS and total subcutaneous or visceral adipose tissue or total lung volumes. However, the patients that died during follow-up had significantly smaller total lung (p=0.04) and skeletal muscle volumes (p=0.01). These differences were also observed when stratified by patient’s sex.
For both RRMM patients and controls, correlation analyses between BMI versus total subcutaneous and visceral adipose tissue revealed a stronger positive correlation with total subcutaneous tissue than visceral adipose tissue (Subcutaneous adipose tissue R squared=0.7294, Visceral adipose tissue R squared=0.2371). The observed median progression free survival durations were 9 months and 7.5 months for recipients of GPRC5D/CD3 and BCMA/CD3 bispecific antibodies respectively.
Conclusions: In a relatively young, non-frail cohort of patients with RRMM treated with bispecific antibodies, low total skeletal muscle and lung volumes as measured by automated BC analysis were negative predictors of survival. Further evaluation of sarcopenia in MM is required as this may represent a potentially modifiable prognostic factor with prehabilitative/rehabilitative exercise and dietary interventions. BC analysis is therefore a useful tool to identify patients who may be at risk of mortality.
Disclosures: Popat: Roche: Honoraria; J&J: Honoraria; Regeneron: Other: IDMC member; Sanofi: Honoraria; GSK: Honoraria, Research Funding; Abbvie: Honoraria; BMS: Honoraria; Pfizer: Honoraria, Research Funding.
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