星空无限传媒cancer researcher Binod Dhakal, MD, associate professor, Hematology and Medical Oncology, presented the first results from the Phase 3 CARTITUDE-4 study at the , the world’s largest cancer conference. He compared results of providing standard of care treatment in 419 patients with multiple myeloma (MM) who had 1-3 prior lines of therapy and were lenalidomide refractory, with results of cilta-cel–a CAR-T therapy, like ide-cel, that binds to B-cell maturation antigen (BCMA) on the surface of myeloma cells.
Results of this global study, published in the in June, showed that cilta-cel reduced the risk of MM progression or death by approximately 74%. “The marked difference between ide-cel and cilta-cel is cilta-cel’s ability to bind to two BCMA sites, as opposed to just one. This could make the difference for patients who require a second form of therapy,” said Dhakal, co-first author of the study.
is one of only two phase 3 clinical trials of CAR-T therapy for MM in early lines of therapy and is the only study so far to evaluate CAR-T therapy in patients after one prior line of therapy. Prognosis for patients with lenalidomide-refractory disease is generally worse than those with lenalidomide-sensitive disease or those who have never previously received lenalidomide (a prescription medicine extensively used as a frontline therapy in adults with MM), with median progression free survival as poor as 12 months.
However, the promising findings presented at ASCO show that in a heavily pretreated, relapsed/refractory population, median progression-free survival with cilta-cel is almost 3 years. The results make cilta-cel the first CAR-T therapy to achieve a significant response for specific subgroups of patients, including those with high-risk disease after the first relapse.
“Since lenalidomide is extensively used as a frontline therapy in myeloma patients, lenalidomide refractoriness early in patient disease course is becoming increasingly common. This rules out the use of lenalidomide-based regimens in subsequent lines. This study is the first of its kind to effectively assess the use of CAR-T therapy as a second line of treatment in patients with progressive disease,” said Dr. Dhakal.