Dr Baz on the Incidence of AEs With Ide-Cel in Triple-Class–Exposed Multiple Myeloma

Rachid Baz, MD, section head, Myeloma, Department of Malignant Hematology, Moffitt Cancer Center; co-director, Pentecost Family Myeloma Research Center, discusses the incidence of cytopenias and infections in patients with multiple myeloma enrolled in the phase 3 KarMMa-3 trial (NCT03651128).

The KarMMa-3 trial evaluated the BCMA-directed CAR T-cell therapy idecabtagene vicleucel (ide-cel; Abecma) vs standard of care (SOC) in patients with triple-class–exposed relapsed/refractory multiple myeloma.

This adverse effect (AE) analysis found that the rate of grade 3/4 cytopenias was higher among patients who received ide-cel than those who received a SOC regimen, Baz says. However, the incidence of cytopenias in this population was time-limited and largely restricted to the first 3 months of treatment. After this time point, the rates of cytopenia decreased and this AE became more manageable, Baz emphasizes. Compared with findings from earlier studies investigating standard treatment regimens in multiple myeloma, KarMMa-3 did not demonstrate higher rates of cytopenias with ide-cel in this population, Baz highlights. For instance, patients with relapsed/refractory multiple myeloma who received ide-cel in the phase 2 KarMMa-1 trial (NCT03361748) experienced rates of cytopenias that were comparable to those observed in the ide-cel arm of KarMMa-3, Baz explains.

Hematologists are typically comfortable with managing cytopenias in patients with multiple myeloma who receive CAR T-cell therapy, and often use growth factor support or transfusion support when necessary, according to Baz. Rarely will patients require additional support measures, such as a stem cell boost, after receiving CAR T-cell therapy, Baz emphasizes.

Additionally, the overall incidence of grade 3/4 infections was high in both arms and remained consistent over time. Any-gradebacterial infections in the KarMMa-3 AE analysis were more common in the first 3 months after infusion, Baz explains. However, beyond the first 3 months, the infection rates were comparable to those observed in multiple myeloma populations receiving other therapies, Baz concludes.