guest ::
| Home > Publications database > Remission conversion drives outcomes after CAR T-cell therapy for multiple myeloma: a registry analysis from the DRST. |
| Home > Publications database > Remission conversion drives outcomes after CAR T-cell therapy for multiple myeloma: a registry analysis from the DRST. |
| Journal Article | DKFZ-2025-02047 |
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
2025
American Society of Hematology
Washington, DC
This record in other databases: 
Please use a persistent id in citations: doi:10.1182/blood.2025028330
Abstract: Cellular therapies targeting B-cell maturation antigen have shown promise in controlled clinical trials, but their impact in broader, diverse patient populations remains underexplored. This study examines the real-world efficacy and safety in 343 triple-class-exposed patients with relapsed and refractory multiple myeloma who received idecabtagene vicleucel (ide-cel; n = 266) or ciltacabtagene autoleucel (cilta-cel; n = 77) after >3 previous lines of therapy in Germany. Cilta-cel, compared with ide-cel, demonstrated superior outcomes, achieving a higher overall response rate (94% vs 82%) and 10-month progression-free survival (PFS; 76% vs 47%). Cilta-cel also led to higher complete response (CR; 61% vs 39%) and improved response conversion, with more patients achieving CR after starting from less than CR before chimeric antigen receptor T-cell (CAR T) therapy. For those attaining CR after therapy, cilta-cel showed longer PFS, especially in patients who entered treatment with a partial response or worse. Cytokine release syndrome was observed in 85% of cilta-cel and 81% of ide-cel cases, predominantly low grade. Immune effector cell-associated neurotoxicity syndrome was more common with cilta-cel (25% vs 15%), although nonrelapse mortality at 10 months was comparable between therapies (7% vs 5%). Weighted multivariable analysis after propensity score matching confirmed a significant advantage in terms of PFS for cilta-cel, with a hazard ratio of 0.48. Overall, outcomes in our registry analysis were comparable with the pivotal trials that led to approval of the respective agents. Cilta-cel demonstrated a greater capacity for response conversion and durable remission. These findings underscore the need for individualized CAR T therapy selection to optimize patient outcomes.
Keyword(s): Humans (MeSH) ; Multiple Myeloma: therapy (MeSH) ; Multiple Myeloma: mortality (MeSH) ; Multiple Myeloma: immunology (MeSH) ; Immunotherapy, Adoptive: adverse effects (MeSH) ; Immunotherapy, Adoptive: methods (MeSH) ; Male (MeSH) ; Registries (MeSH) ; Middle Aged (MeSH) ; Female (MeSH) ; Aged (MeSH) ; Adult (MeSH) ; Receptors, Chimeric Antigen (MeSH) ; Remission Induction (MeSH) ; Treatment Outcome (MeSH) ; Aged, 80 and over (MeSH) ; Antigens, CD19: therapeutic use (MeSH) ; B-Cell Maturation Antigen (MeSH) ; Receptors, Chimeric Antigen ; idecabtagene vicleucel ; Antigens, CD19 ; B-Cell Maturation Antigen
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 20 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
|
The record appears in these collections: |
