Dr Lin on the Characteristics of Patients With Multiple Myeloma and Sustained MRD Negativity in CARTITUDE-1

Yi Lin, MD, PhD, hematologist and oncologist, Department of Hematology, member, CAR T-Cell Therapy Program at Mayo Clinic, discusses the predictive value of baseline characteristics in relation to sustained minimal residual disease (MRD) negativity following treatment with ciltacabtagene autoleucel (cilta-cel; Carvykti) in patients with relapsed/refractory multiple myeloma.

At the 2023 SOHO Annual Meeting, Lin presented data from an analysis of efficacy outcomes and patient characteristics for those with sustained MRD negativity in the phase 1/2 CARTITUDE-1 trial (NCT03548207).

MRD-evaluable patients in this study were categorized into 3 groups based on the duration of MRD negativity: less than 6 months, 6 to 12 months, and more than 12 months. Of the 61 evaluable patients, 56 (91.8%) achieved MRD negativity. Among these patients, 22, 10 and 24 patients sustained MRD negativity for less than 6 months, 6 to 12 months, and more than 12 months, respectively. Results showed that all patients who sustained MRD negativity for at least 6 months achieved a stringent complete response (sCR). Moreover, responders who sustained MRD negativity experienced a longer duration of response compared with those who did not.

Researchers examined the prognostic value of various baseline demographics and disease characteristics seen in these study participants, Lin states. Although patients with sustained MRD negativity for 12 months or more tended to have a longer time from initial diagnosis to CAR T-cell treatment, most baseline characteristics did not vary across the 3 MRD subgroups. Moreover, responses were similar to that of the overall CARTITUDE-1 population, Lin reports. A slight trend toward prolonged response was observed in a small percentage of patients with plasmacytoma, Lin adds. However, no definitive conclusions could be drawn due to the low number of cases, Lin qualifies. Accordingly, investigators concluded that baseline characteristics were not predictive of sustained MRD negativity, she states.

These findings indicate the potential for cilta-cel to produce favorable responses and high MRD negativity rates in patients with relapsed/refractory multiple myeloma regardless of baseline characteristics, Lin emphasizes. Physicians should remain vigilant in follow-up care for patients post-CAR T-cell therapy to better understand the long-term implications and outcomes of this treatment, Lin concludes.