Thomas Martin, MD, spoke about how to increase response durability with ciltacabtagene autoleucel for patients with heavily pretreated multiple myeloma.
Thomas Martin, MD, associate director of the myeloma program at the University of California San Francisco, spoke with CancerNetwork® about the approval of ciltacabtagene autoleucel (Carbykti; cilta-cel) and how investigators can best utilize this treatment for those with relapsed/refractory multiple myeloma.1 This approval comes based on the results of the phase 1b/2 CARTITUDE-1 trial (NCT03548207) in which patients with heavily pretreated multiple myeloma and were given cilta-cel and saw durable responses.2
In this patient population, we must look into how we can make it a longer remission duration for everybody. The currently approved therapeutic idecabtagene vicleucel [Abecma] has a [median] progression-free survival [PFS] of 12 months. We would love for it to be longer than that, right? Maybe we need to do maintenance therapy. Maybe we need to see if we [give] treatment after we give the CAR T-cell therapy, something that can rev up the T-cells, make them last longer, and perhaps provide more of an anti-myeloma effect.
Cilta-cel has a longer PFS [with data recently] presented at the recent [63rd Annual American Society of Hematology Annual Meeting]. The 2-year progression-free survival rate was 60.5%, so people are getting 2 years or more of remission duration. Can we even make it longer by adding? That’s one avenue as to how to make it better for the people with relapsed, triple-class refractory [disease]. The other question for us is if we move it to earlier lines of therapy, will we be able to cure some patients with multiple myeloma? Will their remission duration be longer? If we do it in less heavily pretreated patients where their T-cells are healthier and when their myeloma isn’t as resistant, can we make it last longer? That’s a huge question, and that’s where a lot of the energy is now in proving those points.
1. U.S. FDA Approves CARVYKTI (ciltacabtagene autoleucel), Janssen's first cell therapy, a BCMA-directed CAR-T immunotherapy for the treatment of patients with relapsed or refractory multiple myeloma. News release. Janssen. February 28, 2022. Accessed February 28, 2022. https://prn.to/3vskiZu
2. Martin T, Usmani S, Berdeja J, et al. Updated Results from CARTITUDE-1: Phase 1b/2 study of ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T cell therapy, in patients with relapsed/refractory multiple myeloma. Blood. 2021;138(suppl 1):549. doi:10.1182/blood-2021-146060