Cytopenias Are ‘Limited’ Following Ide-Cel in R/R Multiple Myeloma

Commentary
Video

The safety profile of idecabtagene vicleucel in relapsed/refractory multiple myeloma following the first 3 months of treatment appears to be comparable with standard therapies, says Rachid Baz, MD.

During the 2023 American Society of Hematology (ASH) Annual Meeting and Exposition, Rachid Baz, MD, spoke with CancerNetwork® about how safety data from the phase 3 KarMMa-3 trial (NCT03651128) showed a low rate of cytopenias and infections with idecabtagene vicleucel (ide-cel; Abecma) as a therapy for patients with relapsed/refractory multiple myeloma.

According to Baz, the Myeloma Section head in the Department of Malignant Hematology at Moffitt Cancer Center and co-director of the Pentecost Family Myeloma Research Center, safety signals in the KarMMa-3 trial were expected based on results from a prior assessment of ide-cel in relapsed/refractory multiple myeloma in the phase 2 KarMMa-1 trial (NCT03361748). Additionally, cytopenias and infections generally occurred early during treatment, and the overall safety profile of ide-cel following the first 3 months of therapy appeared to be comparable with standard multiple myeloma treatment options.

Data from the KarMMa-3 trial highlighted that the rates of grade 3/4 cytopenias with ide-cel were 87.1% at fewer than 3 months, 24.1% at more than 3 and fewer than 6 months, and 14.7% at more than 6 months compared with standard regimens. Cytopenias in the ide-cel arm were typically managed with colony-stimulating factor (55.5%), red blood cell transfusions (48.0%), and platelet transfusions (32.0%).

Transcript:

The main implication is that there was not a signal [in KarMMa-3] that we did not anticipate from the KarMMa-1 study. Cytopenias are something hematologists are usually comfortable managing or something comfortable for us to deal with. I typically use growth factor support and transfusion support when needed. It is very rare that patients require things like a stem cell boost. That’s our experience with CAR T so far.

In that specific patient population, we saw that the reassuring part is that a lot of this [toxicity] was limited. We saw it mostly in the first 3 months of treatment.The same was true for infection. When you look at bacterial infection, they were more common in the first 3 months of treatment. Beyond the first 3 months, the rate was not very different than what you would see in a patient population receiving a [standard] myeloma therapy.

Reference

Baz R, Otero PR, Ailawadhi S, et al. Idecabtagene vicleucel (ide-cel) versus standard (std) regimens in patients (pts) with triple-class-exposed (TCE) relapsed and refractory multiple myeloma (RRMM): analysis of cytopenias and infections in pts from KarMMa-3. Blood. 2023;1429(suppl 1):4879. doi:10.1182/blood-2023-174477

Related Videos
A panel of 3 experts on multiple myeloma
A panel of 3 experts on multiple myeloma
A panel of 3 experts on multiple myeloma
Tailoring neoadjuvant therapy regimens for patients with mismatch repair deficient gastroesophageal cancer represents a future step in terms of research.
Not much is currently known about the factors that may predict pathologic responses to neoadjuvant immunotherapy in this population, says Adrienne Bruce Shannon, MD.
The toxicity profile of tislelizumab also appears to look better compared with chemotherapy in metastatic esophageal squamous cell carcinoma.
Patients with unresectable or metastatic esophageal squamous cell carcinoma and higher PD-L1 expression may benefit from treatment with tislelizumab, according to Syma Iqbal, MD.
Quantifying disease volume to help identify potential recurrence following surgery may be a helpful advance, according to Sean Dineen, MD.
Sean Dineen, MD, highlights the removal of abdominal wall lesions and other surgical strategies that may help manage symptoms in patients with cancer.
A panel of 3 experts on multiple myeloma