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Current and Future Perspectives for Bispecific Antibodies in Multiple Myeloma: Learnings from 2023

with Sagar Lonial, Naresh Bumma, Amrita Krishnan, and Sergio Giralt

Monday, March 11, 2024 | 8:00 am EST

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2023-07-24T12:10:46.000Z

Real-world patient cases: CAR T-cell therapy

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Jul 24, 2023
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Learning objective: After reading this article, learners will be able to cite a new clinical development in multiple myeloma.

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During the European Hematology Association (EHA) 2023 Hybrid Congress, the Lymphoma Hub and Multiple Myeloma Hub held a joint satellite session on the ins and outs of CAR T-cells in the real world. 

Here the Multiple Myeloma Hub is pleased to share a real-world patient case as presented by Doris Hansen, Moffitt Cancer Center, Tampa, US.

Real-world patient cases: CAR T-cell therapy

Here, Hansen discusses a case study of a 78-year-old caucasian male with multiple comorbidities and prior exposure to a BCMA-directed agent (Figure 1), they were treated with idecabtagene vicleucel (ide-cel). Hansen uses the case study to examine real-world safety and efficacy data for both ide-cel (Figure 2) and ciltacabtagene autoleucel (cilta-cel), making comparisons with clinical trial data from KarMMa and CARTITUDE-1.1

Figure 1. Patient case study outline* 

BCMA, B-cell maturation antigen; CAD/NSTEMI, coronary artery disease/non-ST-elevation myocardial infarction; CAR, chimeric antigen receptor; cyclo; cyclophosphamide; dara, daratumumab; d, dexamethasone; ECOG, Eastern Cooperative Oncology Group; EF, ejection fraction; HCT, hematopoietic stem cell transplant; IDDM, insulin-dependent diabetes mellitus 2; ide-cel, idecabtagene vicleucel; Ig, immunoglobulin; Isa, isatuximab; Ixa, ixazomib; K, carfilzomib; MM, multiple myeloma; P, pomalidomide; R, lenalidomide; R-ISS, revised International Staging System; s/p, status post; T, thalidomide; V, bortezomib
*Provided by Hansen.1

 

Figure 2. Safety of ide-cel in the real-world setting* 

CRS, cytokine release syndrome; ide-cel, idecabtagene vicleucel; NRM, non-relapse mortality; NT, neurotoxicity; SOC, standard of care.
*Adapted from Hansen, et al.2
ASTCT criteria used for grading CRS and NT.

Watch or download the presentation to learn more about:

  • The safety and efficacy of ide-cel and cilta-cel in the real world compared with clinical trial data
  • The factors associated with poorer response to CAR T cells
  • The discrepancy between real-world patient characteristics and eligibility criteria for clinical trials of CAR T cells
  • The use of CAR therapies in patients ineligible for clinical trials

Key points1,2

  • Best overall response rate to ide-cel and cilta-cel in standard of care setting, 84% and 89%, respectively.
  • Factors associated with poorer response to ide-cel include,
    • prior use of BCMA-targeted therapies;
    • high-risk cytogenetics;
    • ECOG performance status ≥2; and
    • younger age.
  • High-risk cytogenetics were an independent predictor of inferior outcomes with cilta-cel use.
  • Overall, ≥50% of real-world patients with multiple myeloma are ineligible for enrollment in clinical trials of CAR T cells but demonstrated favorable safety and efficacy data in the standard-of-care setting, compared with KarMMa and CARTITUDE-1.
  • Treatment with CAR T-cell therapies such as ide-cel and cilta-cel is feasible in the real-world setting, including in patients ineligible for clinical trial

Session slides

To download the slides presented, click here.

Download here

This activity was supported through an educational grant from Bristol Myers Squibb.

  1. Hansen D. Personal communication; Jun 9, 2023.
  2. Hansen D, Sidana S, Peres L, et al. Idecabtagene vicleucel for relapsed/refractory multiple myeloma: real-world experience from the Myeloma CAR T Consortium. J Clin Oncol. 2023;41(11);2087-2097. DOI: 1200/jco.22.01365

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