Real World Outcomes of Myeloma Patients Treated with BCMA-Targeted Therapy Followed by Ide-Cel

Dr. Christopher Ferreri, MD Anderson Cancer Center, Houston, TX, discusses a study that evaluated the real-world outcomes for patients treated with standard of care ide-cel after having previously received a BCMA-targeted therapy

Abstract title:

Idecabtagene Vicleucel (Ide-cel) Chimeric Antigen Receptor (CAR) T-Cell Therapy in Patients with Relapsed/Refractory Multiple Myeloma (RRMM) Who Have Received a Prior BCMA-Targeted Therapy: Real World, Multi-Institutional Experience

Purpose of the trial:

Ide-cel received regulatory approval for the treatment of patients with RRMM after ≥4 prior lines of therapy based on the results of the pivotal KarMMa trial in which patients achieved an overall response rate (ORR) of 73%, ≥ complete response (CR) in 33%, and median progression free survival (PFS) of 8.8 months (Munshi et al. N Engl J Med 2021). Patients who had previously received a BCMA-targeted therapy (BCMA-TT) were excluded from the KarMMa trial. We evaluated the real-world outcomes for patients treated with standard of care ide-cel after having previously received a BCMA-TT.

Video summary:

Eleven US academic centers contributed data to this effort which included patients who had undergone apheresis up until 5/1/2022, and who were infused with ide-cel with sufficient follow-up duration for at least a day 30 response assessment. The toxicity profile for patients receiving a prior BCMA-TT was similar to those in our cohort who had not received a prior BCMA-TT and to that described in KarMMa. Grade ≥ 3 CRS and ICANS were 2.0% and 8.5% respectively. Patients in the prior BCMA-TT cohort were more likely to have grade 4 thrombocytopenia in the first 30 days after ide-cel infusion (46% v 31.5%; p=0.064) and were more likely to receive a thrombopoietin (TPO) agonist (27% v 12%; p=0.017).

Conclusions:

This multicenter retrospective study characterizes a large cohort of patients who received a prior BCMA-TT before treatment with ide-cel, which is associated with inferior PFS and less likelihood of attaining both an overall response and best response of ≥CR. There was a trend towards worse efficacy outcomes for patients who received ide-cel < 6 months after their prior BCMA-TT, and the timing of ide-cel infusion after prior BCMA-TT warrants further investigation.

Trial information:

ASH 2022: Abstract #766

Authors:

Christopher J. Ferreri, MD, Michelle A.T. Hildebrandt, PhD, Hamza Hashmi, MD, Leyla O. Shune, MD, Joseph P. McGuirk, DO, Douglas W. Sborov, MD, Charlotte B Wagner, PharmD, M. Hakan Kocoglu, MD, Shebli Atrash, MD, Peter M. Voorhees, MD, Jack Khouri, MD, Danai Dima, MD, Aimaz Afrough, MD, Aishwarya Sannareddy, MBBS, Gary Simmons, DO, James Davis, PharmD, Nilesh Kalariya, Lauren C. Peres, PhD, MPH, Melissa Alsina, MD, Frederick L. Locke, MD, Surbhi Sidana, MD, Doris K. Hansen, MD, Krina Patel, MD, MSc and Omar Alexis Castaneda Puglianini, MD