Based on data from the CARTITUDE-1 trial, researchers suggested that ciltacabtagene autoleucel (cilta-cel) exhibited a comparable safety and efficacy profile in the treatment of patients with relapsed or refractory multiple myeloma (MM) either with or without prior allogeneic stem cell transplant (SCT).
They noted patients who have received allogeneic SCT are commonly excluded from chimeric antigen receptor (CAR) T-cell trials, and data on treatment outcomes in these patients are sparse.
“Our findings add to the small body of evidence that will influence clinical decision-making with respect to treatment choices for patients with multiple myeloma who relapse following [allogeneic SCT],” they summarized. The findings were presented in Clinical Lymphoma, Myeloma & Leukemia.
Cilta-cel Appears Unaffected by Prior Allogeneic SCT
The analysis reviewed 97 patients with MM who received a cilta-cel infusion in CARTITUTDE-1, of whom 7 had previously received allogeneic SCT. The 7 patients had received a median of 9 previous lines of therapy (range, 6-14 lines), and their median time since undergoing transplantation was 5.1 years (range, 2.7-6.2 years).
After a median follow-up of 27.7 months, the overall response rate among patients with prior transplantation was 85.7% (n=6). Between patients with and without prior allogeneic SCT, the rates of cytokine release syndrome were 85.7% versus 95.6%, and the rates of immune effector cell-associated neurotoxicity syndrome were 14.3% versus 16.7%, respectively.
According to the report, there were no cases of graft-versus-host disease, although 1 patient with prior allogeneic SCT experienced grade 3 movement and neurocognitive treatment-emergent adverse events. Additionally, 1 patient died due to treatment-related lung abscess, and 1 died due to unrelated liver failure.
Overall, the study’s authors suggested that prior allogeneic SCT did not appear to compromise the safety or efficacy of cilta-cel in patients with relapsed or refractory MM enrolled in the CARTITUDE-1 trial.
They did note that “additional studies are needed to elucidate the effects of both host- and donor-derived CAR T cells to better understand treatment options for patients with multiple myeloma and other hematologic malignancies in the post-allogeneic SCT setting.”