Real-World Experience of Patients With Multiple Myeloma Receiving Ide-Cel After a Prior BCMA-Targeted Therapy

Most patients with multiple myeloma experience disease relapse after treatment with a B-cell maturation antigen-targeted therapy (BCMA-TT), and data describing outcomes for patients treated with sequential BCMA-TT are limited. We analyzed clinical outcomes for patients infused with standard-of-care idecabtagene vicleucel, an anti-BCMA chimeric antigen receptor (CAR) T-cell therapy, at 11 US medical centers. A total of 50 patients with prior BCMA-TT exposure (38 antibody-drug conjugate, 7 bispecific, 5 CAR T) and 153 patients with no prior BCMA-TT were infused with ide-cel, with a median follow-up duration of 4.5 and 6.0 months, respectively. Safety outcomes between cohorts were comparable. The prior BCMA-TT cohort had a lower overall response rate (74% versus 88%; p = 0.021), median duration of response (7.4 versus 9.6 months; p = 0.03), and median progression-free survival (3.2 months versus 9.0 months; p = 0.0002) compared to the cohort without prior BCMA-TT. All five patients who received a prior anti-BCMA CAR T responded to ide-cel, and survival outcomes were best for this subgroup. In conclusion, treatment with ide-cel yielded meaningful clinical responses in real-world patients exposed to a prior BCMA-TT, though response rates and durability were suboptimal compared to those not treated with a prior BCMA-TT

Unraveling the enigma of sarcopenia and sarcopenic obesity in Indian adults with type 2 diabetes – a comparative cross-sectional study

Abstract Background Sarcopenia and sarcopenic obesity are growing concerns associated with increasing diabetes incidence, but data from Indian diabetic cohorts are limited. This study examined the prevalence and clinical factors associated with sarcopenia and sarcopenic obesity. Methods In this cross-sectional study, 750 participants aged 35–70 years were recruited by systematic stratification and a fixed quota sampling technique from medical camps and categorized into diabetic (n = 250), nondiabetic (n = 250), and obese nondiabetic (n = 250) groups. The assessments included questionnaires, muscle mass estimation by bioimpedance analysis, and blood tests. Sarcopenia was defined using the Asian Working Group consensus, and sarcopenic obesity was defined as sarcopenia with a BMI ≥ 25 kg/m2. Logistic regression was used to analyze risk factors. Results Sarcopenia affected 60% of diabetic patients, 28% of nondiabetic patients, and 38% of nonobese nondiabetic patients (p < 0.001). The prevalence of sarcopenic obesity was 40%, 11%, and 30%, respectively (p < 0.001). Diabetes was associated with 2.3-fold greater odds (95% CI 1.1–4.7) of sarcopenia and 2.4-fold greater odds (1.1-5.0) of sarcopenic obesity after adjustment. A duration greater than 10 years, uncontrolled diabetes, age greater than 65 years, low physical activity, hypertension, and dyslipidemia also independently increased the odds. Conclusion Indian adults with type 2 diabetes have a high burden of sarcopenia and sarcopenic obesity. Early optimization of diabetes care and lifestyle changes are vital for preserving muscle health

Secondary monoclonal gammopathy of unknown significance with isotype switching after CAR T-cell therapy for multiple myeloma: A case report

The incidence of secondary monoclonal gammopathy of undetermined significance is limited in patients with multiple myeloma post chimeric antigen receptor T-cell therapy. This is a case of secondary monoclonal gammopathy of undetermined significance with the appearance of distinct paraprotein peaks demonstrating isotype switching from IgA lambda to IgG lambda within 6 months post autologous chimeric antigen receptor T-cell therapy in a 66 year old multiple myeloma patient. Secondary monoclonal gammopathy of undetermined significance with or without isotype switching and/or new paraprotein bands may be a rare but important example of a benign and transient phenomenon representing pseudo-disease progression and potentially associated with longer progression-free survival and better overall outcomes. Although such association remains speculative given paucity of literature and an absence of high-quality data

Quality by design based development of a selective stability-indicating UPLC method of dolutegravir and characterization of its degradation products by UPLC-QTOF-MS/MS

Systematic method development was performed for dolutegravir and its stress degradation products. Structural elucidation of all degradants was carried out.</p