Multiple myeloma is characterized by uncontrolled proliferation of plasma cells in the bone marrow, leading to complications such as anemia, bone lesions, infections, renal dysfunction, and hypercalcemia. Monoclonal antibodies targeting CD38 have expanded treatment options by enabling immune-mediated destruction of malignant plasma cells through mechanisms such as complement activation and antibody-dependent cellular cytotoxicity.

Real-world evidence offers insight into how these therapies perform outside the controlled setting of clinical trials. A retrospective analysis from a tertiary hematology center evaluated patients receiving CD38-targeted monoclonal antibody–based regimens between 2018 and 2024. Data from institutional and regulatory databases were used to assess treatment persistence, adherence, dose intensity, pharmacovigilance, and survival outcomes.

Overall survival in routine clinical practice appeared lower than that reported in registration studies, which may reflect differences in patient populations, including older individuals and those with comorbidities. In relapsed or refractory disease treated with an immunomodulatory-based triplet regimen that included CD38 targeting, overall survival at 63 months was approximately 30%, compared with about 50% reported in clinical trials. Among newly diagnosed transplant-ineligible patients, survival at 30 months approached 75%, more closely aligning with trial observations.

These findings underscore the importance of considering patient heterogeneity and real-world factors when interpreting outcomes, as well as the complementary role of real-world evidence alongside clinical trial data.

How do outcomes with CD38-targeted regimens in your practice compare with those reported in clinical trials? What factors most influence treatment persistence in patients receiving antibody-based therapy for multiple myeloma?