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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Monday, October 3, 2022
Rahul Banerjee, MD, of the University of California, San Francisco, and colleagues evaluated the safety and efficacy of B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy in elderly patients with multiple myeloma. Presented during the 2022 International Myeloma Society (IMS) Annual Meeting and Exposition (Abstract OAB-008), the results of this study suggest that CAR T-cell therapy may be well tolerated and effective in this patient population.
“While limited by small sample size and likely selection bias in favor of healthier-functioning older adults, our analysis did not demonstrate any increases in BCMA CAR T-cell toxicity among patients aged 70 and above,” concluded the investigators. “Hypogammaglobulinemia, while possibly more common numerically in older patients, did not correspond to a higher risk of infections.”
The investigators focused on 69 patients with multiple myeloma who received any BCMA CAR T-cell therapy. Participants were either younger than (n = 54) or at least 70 years old (n = 15) at the time of infusion. Fisher’s and Kruskal-Wallis testings were used to compare patient characteristics.
Patient demographics were consistent across cohorts, although older patients were more likely to receive reduced-dose fludarabine for lymphodepletion (P < .01) and had significantly lower creatinine clearances (P < .01). Additionally, frequencies of any-grade cytokine-release syndrome, immune effector cell–associated neurotoxicity syndrome, and prolonged neutropenia were comparable across both age groups. Of note, all five cases of infection occurred in younger patients.
Although the median progression-free survival and overall survival were not reached in elderly patients, younger individuals had survivals of 13.9 and 30.0 months, respectively. Furthermore, the 3-year survival probability among elderly patients (89%) was significantly higher than that of younger patients (39%). Before day 100 of treatment, two deaths from progressive multiple myeloma were reported—both in younger patients.
Disclosure: Disclosure information was not provided.
2022 IMS Annual Meeting and Exposition
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