In a retrospective study reported in the Journal of Clinical Oncology, Hansen et al found that standard-of-care ciltacabtagene autoleucel was associated with better efficacy outcomes and increased risk of some toxicities vs standard-of-care idecabtagene vicleucel in patients with relapsed or refractory multiple myeloma.
Study Details
Data were from a retrospective chart review of patients with relapsed or refractory multiple myeloma who underwent leukapheresis by the end of December 2022 with the intent to receive standard-of-care idecabtagene vicleucel or ciltacabtagene autoleucel at 19 U.S. institutions.
Key Findings
A total of 641 patients were leukapheresed for idecabtagene vicleucel (n = 386) and ciltacabtagene autoleucel (n = 255). Of them, 586 patients received infusions, including 350 with idecabtagene vicleucel and 236 with ciltacabtagene autoleucel.
Ciltacabtagene autoleucel treatment was associated with significantly better treatment response (odds ratio [OR] for ≥ complete response = 2.42 [95% confidence interval (CI) = 1.63–3.60]), progression-free survival (hazard ratio [HR] = 0.48, 95% CI = 0.36–0.63), and overall survival (HR = 0.67, 95% CI = 0.46–0.97).
Ciltacabtagene autoleucel treatment was associated with significantly higher risks for grade ≥ 3 cytokine-release syndrome (OR = 6.80, 95% CI = 2.28–20.33), infections (OR = 2.03, 95% CI = 1.41–2.92), and delayed neurotoxicity (OR = 20.07, 95% CI = 4.46–90.20) and numerically increased risk for second primary malignancies (OR = 1.77, 95% CI = 0.89–3.56). No differences between groups were observed for immune effector cell–associated neurotoxicity syndrome, any cytokine-release syndrome, severe cytopenia at days 30 and 90, or nonrelapse mortality.
The investigators concluded: “[Ciltacabtagene autoleucel] demonstrated superior efficacy and survival, with higher incidence of certain toxicities, compared with [idecabtagene vicleucel].”
Doris K. Hansen, MD, of H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: The study was supported by grants from the National Cancer Institute, Pentecost Family Myeloma Research Center, and others. For full disclosures of the study authors, visit ascopubs.org.
