Early Research Findings on CAR T-Cell Therapy in Resistant Multiple Myeloma
Posted: Monday, March 16, 2020
LCAR-B38M, a structurally differentiated chimeric antigen receptor (CAR) T-cell therapy, may result in improved survival outcomes for patients with relapsed or refractory multiple myeloma, according to research published in Blood and presented at the 2019 American Society of Hematology Annual Meeting in Orlando (Abstract 579). In the United States, the phase Ib/II CARTITUDE-1 trial of this immunotherapy is ongoing, and in China, a phase II confirmatory trial is underway.
“This study provides evidence that LCAR-B38M is a highly effective therapy for [relapsed/refractory multiple myeloma], regardless of baseline [B-cell maturation antigen] expression,” concluded Bai-Yan Wang, MD, PhD, of the Second Affiliated Hospital of Xi’an Jiaotong University, China, and colleagues.
The findings are from long-term follow-up on participants from the Xi’an site of LEGEND-2, a first-in-human phase I study. A total of 57 patients with relapsed or refractory multiple myeloma who had been exposed to at least three prior lines of therapy underwent 3 days of lymphodepletion via cyclophosphamide, after which LCAR-B38M was infused over three rounds. At a median follow-up of 19 months, the overall response rate was 88%. Among those experiencing a complete response (n = 42), 39 were minimal residual disease–negative. At 18 months, the overall survival rate was 68%, and the progression-free survival rate was 50%. The median overall survival was not yet reached, whereas the median progression-free survival was 20 months.
All patients experienced adverse events, with pyrexia (91%) and cytokine-release syndrome (90%) among the most common. Cytokine-release syndrome primarily occurred as grade 1 (47%) or grade 2 (35%), though 7% of patients experienced a grade 3 event. Overall, grade 3 or higher adverse events were reported in 65% of patients. A total of 17 deaths occurred during the study and follow-up periods, the majority of which (n = 11) were due to progressive disease.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.