Comparability of CAR-T Therapies for Patients With R/R Multiple Myeloma

At the 2025 Lymphoma, Leukemia & Myeloma (LL&M) Winter Symposium in Miami, Florida, Mateo Mejia Saldarriaga, MD, Weill Cornell Medicine Multiple Myeloma Center, New York, New York, shared updates on the latest trial data on the efficacy and utilization of CAR T-cell therapies for treating patients with relapsed/refractory (R/R) multiple myeloma (MM).

Transcript:

My name is Mateo Mejia. I'm an assistant professor at the Weill Cornell Medicine Multiple Myeloma Center. I'm here in Miami for the LL&M Winter Symposium. We talked a little bit today about the role or some updates on CAR-T for the management of relapsed/refractory myeloma, especially with a lot of emphasis on the data that was presented recently at IMS and ASH.

One of the most salient features was the update on the CARTITUDE-4 data that is using ciltacabtagene autoleucel in 1 to 3 lines of treatment and compared it to physician's choice regimen. The 2 key points to highlight was 1, the updated data on the benefit of ciltacabtagene autoleucel when compared to the control group in terms of overall survival. This again highlights the high efficacy of the product of ciltacabtagene autoleucel, and we knew it had a really strong [progression-free survival] (PFS) advantage, but the overall survival (OS), again, highlights how effective is this compared to in the early relapse setting?

One of the points I would like to make is that, in this trial, they did not allow crossover. This might be the reason why we're seeing such a pronounced OS, compared to idecabtagene vicleucel. The other point that we talked a lot about was the very reassuring [minimal residual disease] (MRD) negativity data with ciltacabtagene autoleucel.

In CARTITUDE-4, we have not only very deep MRD, up to 80%—and of the cases, when we talk about 10 to the -5, when we go to the 10 to the -6, we're talking about actually a very similar percentage telling us that when you achieve an MRD negative, they're often very deep. But I think what is striking as well is how fast these responses happen.

The medium time to MRD was in most of the cases less than 6 months. We talk a little bit as well about anitocabtagene autoleucel, which is another BCMA that was presented at ASH. The most important data for this product is that it seems very effective and [has an] overall response rate of about 90%, which is comparable to ciltacabtagene autoleucel and idecabtagene vicleucel.

Now that we have almost 140 patients treated with anitocabtagene autoleucel, there was no evidence of Parkinsonian or late neurotoxicity, which is one of the main concerns when we talk about doing, CAR T in earlier lines. We also talked a little bit of some products that will come in the later in the future, arlocabtagene autoleucel, GPRC5D-targeted CAR-T, and some other earlier phase data, for example with GPRC5D, BCMA products or BCMA CD19 products.

Source:

Mejia M. Updates in Relapsed or Refractory CAR-T Therapy. Presented at Lymphoma, Leukemia & Winter Symposium; February 7-9, 2025. Miami, FL.