Dr Mouhieddine on Clinical Implications of Ferritin and ALC as Biomarkers in Myeloma

“Although our [findings cannot be fully implemented into] clinical practice right now, they will pave the road for future studies and more [effective treatments] we can do in the future.”

Tarek Mouhieddine, MD, a medical oncologist at Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School, discussed the notable findings from a retrospective study of the potential utility of ferritin and absolute lymphocyte count (ALC) as biomarkers of response to bispecific antibodies for the treatment of patients with relapsed/refractory multiple myeloma.

Findings from the study, which were presented during the 22nd Annual International Myeloma Society Meeting and Exposition, revealed that patients (n = 325) with higher ferritin levels had a shorter median progression-free survival (PFS), Mouhieddine said. Specifically, patients with a ferritin level of 400 ng/mL or below (n = 216) achieved a median PFS of 16.3 months compared with 5.1 months among those with a ferritin level above 400 ng/mL (P = .00029). The respective overall response rates (ORRs) were 74.8% and 62.5% (P = .033). The median overall survival (OS) was not reached (NR) vs 13.87 months, respectively (P < .0001), and the respective deep response rates were 60.6% and 43.3% (P = .005).

Patients with lower ALC experienced worse efficacy outcomes compared with those with higher ALC, Mouhieddine explained. Patients with an ALC greater than 0.9 x 10³/μL (n = 161) experienced a median PFS of 22.17 months compared with 6.87 months among those with an ALC of 0.9 x 10³/μL or below (n = 158; P = .00068). The complete response rates in this population were 46.8% and 28.4%, respectively (P = .005). The respective median OS values were NR and 49.1 months (P = .1).

Although ALC and ferritin levels appear to have some predictive utility in terms of response to bispecific antibodies, they are not the only factors that could have an effect on response, Mouhieddine stressed. These findings cannot be fully implemented into clinical practice yet, but they will serve as the basis for future research in this area, he concluded.