ASH

ASH 2024: CAR T-cell therapies compared in relapsed/refractory multiple myeloma

December 13, 2024

Study design: This retrospective chart review included 641 patients with relapsed/refractory multiple myeloma (RRMM) from 19 U.S. institutions, comparing ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) CAR T-cell therapies. An inverse probability of treatment weighting approach balanced patient characteristics, and logistic regression and Cox proportional hazard models assessed safety, efficacy, and survival. A total of 586 patients were infused (n=350 for ide-cel; n=236 for cilta-cel) with a median follow-up of 13.0 and 12.6 months, respectively.

Results: Compared with ide-cel, cilta-cel was associated with better treatment responses of ≥ complete response (odds ratio [OR], 2.38; 95% CI, 1.61-3.51; p<0.001) and ≥ partial response (OR, 1.74; 95% CI, 0.99-3.05; p=0.06). Cilta-cel-treated patients also had longer progression-free survival and overall survival relative to ide-cel. However, those treated with cilta-cel had higher odds of grade ≥3 cytokine release syndrome (OR, 5.52; 95% CI, 1.76-17.30; p = 0.004), infections (OR, 2.07; 95% CI, 1.44-2.97; p < 0.001), and delayed neurotoxicity (OR, 20.97; 95% CI, 4.75-92.42; p < 0.001) compared with ide-cel.

Impact on clinical practice: The superior efficacy of cilta-cel must be balanced against its higher toxicity profile. Clinicians should consider individual patient risk factors and preferences when selecting CAR T-cell therapies for RRMM. This study provides critical insights for optimizing treatment strategies and improving patient outcome.

Source:

Hansen, D. et al. (2024, December 9). Comparative Safety and Efficacy of Ciltacabtagene Autoleucel and Idecabtagene Vicleucel CAR T-Cell Therapies in Relapsed or Refractory Multiple Myeloma. Oral abstract #936. Presented at American Society of Hematology Annual Meeting & Exposition. https://ash.confex.com/ash/2024/webprogram/Paper194390.html