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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Thursday, December 1, 2022
T-cell redirection therapies, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies, have demonstrated antitumor activity in heavily pretreated patients with relapsed or refractory multiple myeloma; however, data regarding salvage therapy options after relapse are limited. In the journal Blood Advances, Samir Parekh, MD, of the Icahn School of Medicine at Mount Sinai, New York, and colleagues suggested sequential use of different T-cell redirection therapies is feasible and may result in deep and durable responses.
“While conventional salvage therapy had a relatively good overall response rate of around 50%, it did not lead to durable responses, which translated to significantly lower progression-free and overall survival,” the investigators remarked. “On the other hand, transitioning from a bispecific antibody to another T-cell redirection therapy yielded an overall response rate of over 80%, with a median progression-free survival of 28.9 months and a median overall survival that was not reached.”
The investigators focused on 58 patients who experienced disease progression after participating in a bispecific antibody trial and were subsequently administered salvage therapy. Patients were followed for a median of 30.5 months and underwent a median of two additional salvage therapies over that period. A total of 19 patients received T-cell redirection as a first salvage therapy (bispecific antibody: n = 10; CAR T-cell: n = 9). T-cell redirection was administered as a second salvage therapy in 10 patients. The median durations of progression-free survival with T-cell redirection as first and second salvage therapies were 28.9 and 30.9 months, respectively. The 2-year overall survival rate was 62%.
“Future clinical trials incorporating sequential combinations of T-cell redirection therapy will build upon these findings to further develop treatment guidelines and improve long-term outcomes for patients with multiple myeloma,” concluded Dr. Parekh in a Mount Sinai Health System press release.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.
