Dr. Lin on the Emergence of CAR T-Cell Therapy in Multiple Myeloma

Yi Lin, MD, PhD, consultant, Division of Hematology, Department of Internal Medicine, consultant, Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, assistant professor of medicine and oncology, Mayo Clinic, discusses the emergence of CAR T-cell therapy in multiple myeloma.

Idecabtagene vicleucel (ide-cel; bb2121) and ciltacabtagene autoleucel (cilta-cel; JNJ-68284528) are investigational BCMA-directed CAR T-cell products that were evaluated in the phase 2 KarMMA and phase 1b/2 CARTITUDE-1 trials, respectively.

Notably, on September 22, 2020, the FDA granted a priority review designation to a biologics license application (BLA) for ide-cel for the treatment of patients with triple-class refractory multiple myeloma. A BLA has not yet been submitted for cilta-cel; however, due to encouraging efficacy results, the field is preparing for a submission, Lin says. 

Notably, the studies enrolled heavily pretreated patients with multiple myeloma who had poor-risk cytogenetics and penta-refractory disease. High overall response rates were observed in patients who received a single infusion of ide-cel or cilta-cel, explains Lin. In addition, a high percentage of patients achieved deep responses, such as complete remissions (CR) or stringent CRs, as well as minimal residual disease negativity. The median progression-free survival was around 8.8 months with ide-cel and around 12 months with cilta-cel. These results suggest that patients who have been on continuous treatment throughout their disease course can benefit with a single infusion of CAR T-cell therapy, Lin concludes.