Impact of response to bridging therapy on outcomes following cilta-cel infusion

Post hoc analyses from the phase III CARTITUDE-4 trial (NCT04181827), evaluating the correlation between response to bridging therapy and post-infusion outcomes with ciltacabtagene autoleucel (cilta-cel) in 196 patients with relapsed, lenalidomide-refractory multiple myeloma (MM), were presented by Binod Dhakal at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition, December 6–9, 2025, Orlando, US. Bridging therapies included pomalidomide, bortezomib, and dexamethasone (PVd) or daratumumab, pomalidomide, and dexamethasone (DPd).

Key data: Patients who experienced a very good partial response or better (≥VGPR) after bridging therapy had numerically longer 30-month progression-free survival (PFS; 75.9%) and overall survival (OS; 85.1%) vs patients with progressive disease (PD), whose corresponding rates were 30.0% and 40.0%, respectively. Rates of several adverse events (AEs) of special interest were lower among patients achieving deeper responses to bridging therapy, with no movement or neurocognitive treatment-emergent AEs (MNTs) reported in patients experiencing partial response or better (≥PR). Fatal infections occurred in 2.4% of patients with ≥VGPR compared with 15.0% of those with PD.

Key learning: Deeper response to bridging therapy prior to cilta-cel infusion was associated with longer PFS and OS, fewer neurocognitive AEs, and lower rates of fatal infection. These findings highlight the potential clinical relevance of optimizing disease control during the bridging period.