ASCO20: Update on BCMA-Directed CAR-T Cell Therapy for Resistant Myeloma
Posted: Tuesday, June 23, 2020
According to updated results from the CARTITUDE-1 trial, presented during the ASCO20 Virtual Scientific Program (Abstract 8505), JNJ-68284528 (JNJ-4528), a chimeric antigen receptor (CAR) T-cell therapy, may lead to clinical responses in patients with resistant multiple myeloma. This immunotherapy contains two single-domain antibodies that target B-cell maturation antigens (BCMAs).
“These responses were early, deep, and durable at a low dose of CAR T cells,” concluded Jesus G. Berdeja, MD, of the Sarah Cannon Research Institute in Nashville, and colleagues.
The phase Ib trial included 29 patients with measurable multiple myeloma who had received either three or more previous treatments or were double-refractory and had received anti-CD38 antibodies. Patients received a single infusion of a median of 0.73 x 106 CAR-positive viable T cells/kg of JNJ-4528 after undergoing 3 days of cyclophosphamide plus fludarabine for lymphodepletion.
At a median follow-up of 9 months, the overall response rate was 100%, including 22 stringent complete responses (76%), 6 very good partial responses (21%), and 1 partial response (3%). A total of 26 patients were progression-free, and the longest ongoing response was 15 months. At individual 6-month follow-ups, 22 patients had peripheral blood levels of JNJ-4528 that were below the level of quantification. The investigators believe this finding may indicate the lingering of CAR T cells in peripheral blood is not associated with deepening of response. The 6-month progression-free survival rate was 93%. Of the 16 patients evaluable at 6 months, all were minimal residual disease–negative.
Neutropenia, cytokine-release syndrome, and thrombocytopenia were the most commonly occurring adverse events at 100%, 93%, and 93%, respectively. Cytokine-release syndrome was grade 1 or 2 for 25 patients, grade 3 for 1 patient, and grade 5 for 1 patient, and the median time of onset was 7 days. Of the hematologic adverse events grade 3 or higher, the most frequent toxicities were neutropenia, thrombocytopenia, and leukopenia.
Disclosure: For full disclosures of the study authors, visit meetinglibrary.asco.org.