Real-world experience of patients with multiple myeloma receiving ide-cel after a prior BCMA-targeted therapy
Christopher J. Ferreri, Michelle A.T. Hildebrandt, Hamza Hashmi, Leyla Shune, Joseph P. McGuirk, Douglas W. Sborov, Charlotte B Wagner, Mehmet H. Kocoglu, Aaron P. Rapoport, Shebli Atrash, Peter M. Voorhees, Jack Khouri, Danai Dima, Aimaz Afrough, Gurbakhash Kaur, Larry D. Anderson, Gary Simmons, James A. Davis, Nilesh Kalariya, Lauren C. Peres, Yi Lin, Murali Janakiram, Omar Nadeem, Melissa Alsina, Frederick L. Locke, Surbhi Sidana, Doris K. Hansen, Krina K. Patel, Omar Castañeda Puglianini
Abstract
Most patients with multiple myeloma experience disease relapse after treatment with a B-cell maturation antigen-targeted therapy (BCMA-TT), and data describing outcomes for patients treated with sequential BCMA-TT are limited. We analyzed clinical outcomes for patients infused with standard-of-care idecabtagene vicleucel, an anti-BCMA chimeric antigen receptor (CAR) T-cell therapy, at 11 US medical centers. A total of 50 patients with prior BCMA-TT exposure (38 antibody-drug conjugate, 7 bispecific, 5 CAR T) and 153 patients with no prior BCMA-TT were infused with ide-cel, with a median follow-up duration of 4.5 and 6.0 months, respectively. Safety outcomes between cohorts were comparable. The prior BCMA-TT cohort had a lower overall response rate (74% versus 88%; p = 0.021), median duration of response (7.4 versus 9.6 months; p = 0.03), and median progression-free survival (3.2 months versus 9.0 months; p = 0.0002) compared to the cohort without prior BCMA-TT. All five patients who received a prior anti-BCMA CAR T responded to ide-cel, and survival outcomes were best for this subgroup. In conclusion, treatment with ide-cel yielded meaningful clinical responses in real-world patients exposed to a prior BCMA-TT, though response rates and durability were suboptimal compared to those not treated with a prior BCMA-TT.