Idecabtagene Vicleucel for Relapsed or Refractory Multiple Myeloma
Posted: Tuesday, July 7, 2020
According to Nikhil C. Munshi, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues, the B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T-cell therapy idecabtagene vicleucel seems to confer deep and durable responses, with acceptable toxicity, in patients with triple-class–exposed relapsed or refractory multiple myeloma. The results of the phase II KarMMa trial were presented during the ASCO20 Virtual Scientific Program (Abstract 8503).
“Patients with relapsed and refractory multiple myeloma have a decreased life expectancy, with no clear standard of care and limited responses to currently available treatment options, leaving them in critical need of new therapies,” Dr. Munshi stated in a press release. “The hematology and oncology community look forward to the potential application of idecabtagene vicleucel in future clinical practice.”
A total of 128 patients who were refractory after exposure to at least three prior therapies received the experimental treatment. Each patient underwent a lymphodepletion regimen (cyclophosphamide, fludarabine). Subsequently, idecabtagene vicleucel was administered across target dose levels of 150 (n = 4), 300 (n = 70), and 450 (n = 54) x 106 CAR-positive T cells. Follow-up data were provided for an average of 11.3 months.
In the total patient population, the objective response rate and median duration of progression-free survival were 73% and 8.6 months, respectively. Idecabtagene vicleucel demonstrated objective response rates of at least 50% in all subgroups, which included older and high-risk patients. The objective response rate and administered dosage appeared to be positively correlated (50%, 69%, and 82%, respectively). The median duration of progression-free survival also seemed to follow this trend at dose levels of 300 and 450 x 106 CAR-positive T cells (5.8 and 11.3 months, respectively). The most frequently reported toxicities were cytopenia (97%) and cytokine-release syndrome (84%). After 6 and 12 months, CAR-positive T cells were detected in 59% and 36% of patients, respectively.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
