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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Monday, February 6, 2023
Christopher J. Ferreri, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues assessed real-world outcomes of patients with multiple myeloma who received idecabtagene vicleucel—a chimeric antigen receptor (CAR) T-cell therapy—followed by B-cell maturation antigen (BCMA)-targeted therapy. Presented during the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 766), the results of this study suggest the timing of subsequent CAR T-cell therapy may impact efficacy outcomes.
The investigators compared the data of 50 patients who received BCMA-targeted therapy prior to undergoing CAR T-cell therapy with idecabtagene vicleucel with those of 153 individuals with no prior BCMA therapy. Participants who died of infection or treatment-related toxicity were not considered evaluable for response but were included in the survival and safety analyses.
Of the total, 49 patients were evaluable for response. The median number of prior therapy lines was nine, with 88% of patients undergoing prior autologous stem cell transplantation. Individuals who received prior BCMA therapy were more likely to have more prior therapy lines (P < .0001) and were more likely to have penta-refractory disease (P = .002) compared with those who did not.
Of note, patients who received BCMA therapy demonstrated a significantly lower overall response rate (P = .021) and lower best response of at least a complete response (P = .018) than those without prior treatment. Furthermore, participants who received BCMA therapy up to 6 months prior to idecabtagene vicleucel showed lower rates of overall response and median progression-free survival.
Finally, the toxicity profile was similar among patients receiving prior BCMA-targeted therapy and those who did not receive it. Adverse events such as grade 3 or higher immune effector cell–associated neurotoxicity syndrome and cytokine-release syndrome were uncommon (8.5% and 2.0%). Of note, grade 4 thrombocytopenia was commonly reported within the first 30 days after CAR T-cell therapy among those receiving BCMA-targeted therapy.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2022 ASH Annual Meeting and Exposition
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