Abstract
Use of BCMA Chimeric Antigen Receptor T-Cell (CAR-T) Therapy Versus BCMA T-Cell Engagers in BCMA-Exposed Relapsed/Refractory Multiple Myeloma
Transplantation and cellular therapy, Vol.31(2 Supplement), pp.S419-S419
02/2025
DOI: 10.1016/j.jtct.2025.01.641
Abstract
B-cell maturation antigen (BCMA)-direct therapies (BDT) has changed the landscape of multiple myeloma management. Several different BDTs are currently approved: 2 T-cell engagers (TCE) - teclistamab and elranatamab, and 2 chimeric antigen receptor T-cell (CAR-T) therapies – Idecabtagene viceleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel). With several options, there are concerns about the most effective way to sequence multiple BDTs. Our study aims to evaluate the efficacy of BCMA TCE in comparison to BCMA CAR-T post-BDT in relapsed/refractory MM (RRMM).
A multicenter, retrospective review was conducted. Ninety-five patients (pts) were include with RRMM who received either BCMA TCE or BCMA CAR-T following a previous BDT. The prior BDT could have been standard of care or investigational products. Overall response rate (ORR) was evaluated using the International Myeloma Working Group (IMWG) criteria. Descriptive statistics were utilized for demographics and ORR. Fisher's exact was used to analyze contingency tables. Wilcoxon rank-sum test was used to compare two independent samples.
Forty-four percent of patients received a BCMA CAR-T as the second BDT (42 pts) and 56% received BCMA TCE as the second BDT (53 pts). The median age was 66 years (range: 42-83) for both groups. Twenty six percent vs. 28% had stage 3 disease per the revised international staging system (R-ISS) in BCMA CAR-T vs. TCE groups, respectively. Forty-three percent vs. 57% had high-risk cytogenetics, 43% vs. 42% had extramedullary disease and 86% vs. 92% had triple refractory disease in the BCMA CAR-T vs. TCE groups, respectively. The most common prior BDT in the BCMA CAR-T cohort was antibody drug conjugate (ADC) at 64%, followed by TCE at 29%. In the BCMA TCE cohort, the most common prior BDT was CAR-T at 75%, followed by ADC at 23%.
The ORR with a second BDT was significantly higher in the BCMA CAR-T group compared to the BCMA TCE group, at 79% versus 51% (p<0.001). Additionally, the median PFS was 6 months (95% CI: 5-14) for BCMA CAR-T and 2 months (95% CI: 1-8) for BCMA TCE (p=0.057). The median OS was 30 months (95% CI: 30-NR) for BCMA CAR-T and 12 months (95% CI: 7-NR) for BCMA TCE (p=0.008). Disease progression was the most common cause of death in both groups, accounting for 16 (33%) vs. 18 (29%) deaths in patients receiving BCMA CAR-T and TCE, respectively.
Our study showed significant efficacy with BCMA CAR-T and BCM TCE. However, improved depth of response, as well as longer PFS and OS was seen in the BCMA CAR-T cohort compared to BCMA TCE cohort. With the recent approval of CAR-T for early relapse, sequencing of BCMA agents should be evaluated in prospective trials
Details
- Title: Subtitle
- Use of BCMA Chimeric Antigen Receptor T-Cell (CAR-T) Therapy Versus BCMA T-Cell Engagers in BCMA-Exposed Relapsed/Refractory Multiple Myeloma
- Creators
- Jordan Snyder - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSNausheen Ahmed - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSZahra Mahmoudjafari - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSAl-Ola Abdallah - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSJoseph P McGuirk - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSMuhammad Umair Mushtaq - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSAlma Habib - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSDr. Abdullah Mohammad Khan - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSMehak Masood Laharwal - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSPrerna Mewawalla - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSMarshall McKenna - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSYun Kyoung Tiger - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSHira Shaikh - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSAndrew Vegel - University of IowaEmily Struble - University of IowaJonathan Lochner - University of IowaChristopher Sun Strouse - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSKimberly Green - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSJames Davis - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSHamza Hashmi - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSShebli Atrash - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSReed Friend - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KSBarry Paul - US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KS
- Resource Type
- Abstract
- Publication Details
- Transplantation and cellular therapy, Vol.31(2 Supplement), pp.S419-S419
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jtct.2025.01.641
- ISSN
- 2666-6367
- eISSN
- 2666-6367
- Language
- English
- Date published
- 02/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984795376902771
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