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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Friday, February 10, 2023
Research presented at the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 250) suggests that B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T-cell therapies resulted in high overall response rates, although progression-free survival in these patients remained low. Patients who experienced disease progression after this combination immunotherapy may benefit from salvage treatment.
“Subsequent BCMA-directed immunotherapies including alternative BCMA CAR-T or [bispecific antibodies] may be effective after relapse from initial BCMA CAR-T,” concluded Alfred Chung, MD, of the University of California, San Francisco, and colleagues. “Following BCMA CAR-T relapse, [patients] may also respond to therapies that they were previously deemed refractory to, but the duration of responses appears limited.”
The retrospective analysis included 78 patients with resistant multiple myeloma who received BCMA CAR T-cell therapy between January 2017 and June 2022. Median progression-free survival was 13 months, and the 2-year progression-free survival rate was 34.6%. At a median follow-up of 21.3 months, median overall survival was 31.4 months, and the 2-year overall survival rate was 69%. A total of 42 patients experienced disease progression after CAR T-cell therapy. Of them, 88% underwent at least one subsequent salvage therapy.
Median overall survival after progressive disease on CAR T-cell therapy was 14.8 months. Of the eight patients who underwent subsequent BCMA-targeted therapy after disease progression, median overall survival was 18 months. Some patients who had been refractory to certain treatment classes prior to receiving CAR T-cell therapy, such as alkylator or CD38 therapy, demonstrated treatment response after relapse.
Median patient age was 64.5 years. Patients underwent a median of seven lines of prior therapy. Among those enrolled, 59% had high-risk cytogenetics, 64% were triple-class–refractory, and 28% were penta-refractory.
“Novel therapies and the identification of new therapeutic targets are greatly needed for this patient population,” noted the authors.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2022 ASH Annual Meeting and Exposition
