The following is a summary of “Idecabtagene Vicleucel for Relapsed/Refractory Multiple Myeloma: Real-World Experience From the Myeloma CAR T Consortium,” published in the April 2023 issue of Oncology by Hansen, et al.
Idecabtagene vicleucel (ide-cel) is an autologous chimeric antigen receptor T-cell therapy for treating relapsed/refractory multiple myeloma (RRMM). The therapy was approved based on the phase II KarMMa trial demonstrating good response rates of 73% and 33%, respectively. For a study, researchers sought to report the clinical outcomes of ide-cel used as standard-of-care (SOC) therapy based on the commercial Food and Drug Administration label.
The retrospective data of patients with RRMM who underwent leukapheresis for SOC ide-cel treatment were collected from 11 US institutions till February 28, 2022. Toxicities and responses were graded according to the American Society for Transplantation and Cellular Therapy guidelines and the International Myeloma Working Group response criteria, respectively.
Out of 196 patients, 159 received ide-cel. Of these, 75% of patients were ineligible for the KarMMa trial due to comorbidities at the time of leukapheresis. Cytokine release syndrome and neurotoxicity of any grade and grade ≥ 3 were reported in 82.3% and 18.6% of patients, respectively. The best overall and ≥ complete response rates were 84% and 42%, respectively. The median progression-free survival at a median follow-up of 6.1 months from chimeric antigen receptor T infusion was 8.5 months (95% CI, 6.5 to not reached), and the median overall survival was 12.5 months (95% CI, 11.3 to not reached). Multivariable analysis showed that patients with previous exposure to B-cell maturation antigen–targeted therapy, high-risk cytogenetics, Eastern Cooperative Oncology Group performance status ≥ 2 at lymphodepletion, and younger age had inferior progression-free survival.
The safety and efficacy of ide-cel in RRMM patients in the SOC setting were comparable to those in the phase II KarMMa trial, even though most patients (75%) did not meet the trial eligibility criteria.