Sequential BCMA CAR T-cell therapy in refractory multiple myeloma
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
Abstract
Multiple myeloma (MM) relapsing after B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T-cell treatment remains a therapeutic challenge. Data on re-exposure to CAR T-cell therapy targeting the same antigen are scarce. We analyzed 10 heavily pretreated patients with RRMM at 3 medical centers treated with the commercially approved CAR T-cell therapy product idecabtagene vicleucel in a real-world setting. Upon relapse, all patients received ciltacabtagene autoleucel as a second CAR T-cell therapy infusion, with bridging treatments permitted between both therapies. Sequential therapy with BCMA-directed CAR T-cell therapy was safe, with no higher-grade immune-cell-associated side effects or new safety signals. We found robust CAR T-cell therapy expansion and high response rates (100% with at least very good partial response, with 60% achieving minimal residual disease negativity), with an estimated progression-free survival of 64.8% (95% confidence interval, 39%-100%) at 6 months after the second CAR T-cell treatment. Duration of response to first CAR T-cell therapy was predictive for durable responses to the second CAR T-cell therapy product. Loss of BCMA antigen occurred in only 1 of 3 patients relapsing after ciltacabtagene autoleucel. Two of three relapsing patients died within a year, and showed no further response to bispecific antibody treatment. To our knowledge, this study provides the first real-world evidence that sequential treatment with 2 different commercially approved BCMA CAR T-cell therapy products is both feasible and effective, particularly in patients with prolonged responses to initial BCMA CAR T-cell therapy.
Details
| Originalsprache | Englisch |
|---|---|
| Seiten (von - bis) | 4624-4630 |
| Seitenumfang | 7 |
| Fachzeitschrift | Blood advances |
| Jahrgang | 9 |
| Ausgabenummer | 18 |
| Publikationsstatus | Veröffentlicht - 23 Sept. 2025 |
| Peer-Review-Status | Ja |
Externe IDs
| PubMedCentral | PMC12455134 |
|---|---|
| Scopus | 105015731172 |
Schlagworte
Schlagwörter
- Humans, Multiple Myeloma/therapy, B-Cell Maturation Antigen/immunology, Immunotherapy, Adoptive/methods, Middle Aged, Male, Receptors, Chimeric Antigen/immunology, Aged, Female, Treatment Outcome, Adult