Dr. Shah on the Clinical Implications of Ide-Cel in Relapsed/Refractory Myeloma

Nina Shah, MD, a hematologist and oncologist, and an associate professor of medicine, Department of Medicine, at the University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses the clinical implications of idecabtagene vicleucel (ide-cel; Abecma) in patients with relapsed/refractory multiple myeloma.

The BCMA-directed CAR T-cell therapy ide-cel was FDA approved in March 2021 for use in patients who had received 4 or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody, based on data from the phase 2 KarMMa trial (NCT03361748). Response rates were over 80% in the subset of patients who received the agent at a dose of 450 × 106, and the median progression-free survival was approximately 1 year. Additionally, updated data show a median overall survival of almost 2 years with the product, Shah says.

The agent has been revolutionary for patients, and it is important to maintain access to its use while leaving room for other therapies that could potentially receive regulatory approval like ciltacabtagene autoleucel, according to Shah. Additionally, it is crucial to inquire about ide-cel at the time of the first progression, Shah adds. Ideally, utilizing ide-cel will result in a treatment-free interval for patients with multiple myeloma, Shah concludes.