Early mortality with bispecific antibody therapy in RRMM: an IMWG immunotherapy database real-world analysis

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: 34% early mortality rate (148/441 patients)

• Primary Outcome: Early mortality within 12 months of bispecific antibody initiation

• Nnt Or Sensitivity: Median time to death: 2.87 months (IQR 1.38-6.85)

• Confidence Interval: Not reported in abstract

Clinical Application

Highly applicable as bispecific antibodies are available through PBS Special Access Scheme and clinical trials Relevant for Australian haematologists managing RRMM patients. Results inform consent discussions and supportive care planning. May influence PBS access criteria and clinical guidelines Australian patients with relapsed/refractory multiple myeloma receiving bispecific antibody therapy

Abstract

Recent therapeutic advances, including bispecific antibodies (bsAbs), have improved outcomes for patients with relapsed/refractory multiple myeloma (RRMM). However, early mortality (EM) remains a significant challenge, even in the era of novel immunotherapies. We conducted a multicenter, retrospective analysis of real-world patients with RRMM treated with commercial bsAbs to evaluate the incidence and causes of EM. Between May 2022 and June 2025, a total of 441 patients were treated across 7 countries. EM, defined as death within 12 months of therapy initiation, occurred in 148 patients (34%), with a median time from bsAb initiation to death of 2.87 months (interquartile range, 1.38-6.85). The leading cause of EM was progressive disease (72%), followed by infection (13%); regardless of the cause of death, 82% had active disease at the time of death. Our findings highlight that despite encouraging efficacy, EM remains high among real-world bsAb recipients, emphasizing the need for improved disease control strategies and supportive care interventions.

References

1. 1.Tan, C. R., Usmani, S., Derkach, A., de Meneze Silva Corraes, A., Parrondo, R., Ailawadhi, S., Asoori, S., Dave, M., Popat, R., Morjaria, O., Hajek, R., Mihalyova, J., Htut, M., Janakiram, M., Visram, A., Kastritis, E., Dimopoulos, M. A., Martínez-López, J., Nagarajan, C., Bal, S., Costa, L. J., Einsele, H., Steinbrunn, T., Waldschmidt, J. M., Riedhammer, C., Banerjee, R., Chng, W. J., Tso, A., Lin, Y., Martin, T., & Mian, H. (2026). Early mortality with bispecific antibody therapy in RRMM: an IMWG immunotherapy database real-world analysis. Blood Advances. https://doi.org/10.1182/bloodadvances.2025019231