Phase 1b/2 study of ciltacabtagene autoleucel, a BCMA-directed CAR-T cell therapy, in patients with relapsed/refractory multiple myeloma (CARTITUDE-1): Two years post-LPI.

Authors

Saad Usmani

Saad Zafar Usmani

Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY

Saad Zafar Usmani , Thomas G. Martin , Jesus G. Berdeja , Andrzej J. Jakubowiak , Mounzer E. Agha , Adam D. Cohen , Abhinav Deol , Myo Htut , Alexander M. Lesokhin , Nikhil C. Munshi , Elizabeth O'Donnell , Carolyn Chang Jackson , Tzu-min Yeh , Arnob Banerjee , Enrique Zudaire , Deepu Madduri , Changwei Zhou , Lida Bubuteishvili-Pacaud , Yi Lin , Sundar Jagannath

Organizations

Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, Sarah Cannon Research Institute, Nashville, TN, University of Chicago, Chicago, IL, UPMC Hillman Cancer Center, Pittsburgh, PA, University of Pennsylvania, Philadelphia, PA, Karmanos Cancer Institute, Wayne State University, Detroit, MI, City of Hope Comprehensive Cancer Center, Duarte, CA, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Janssen R&D, Raritan, NJ, Janssen R&D, Spring House, PA, Legend Biotech USA, Piscataway, NJ, Mayo Clinic, Rochester, MN, Mount Sinai Medical Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company
Pharmaceutical/Biotech Company

Background: Ciltacabtagene autoleucel (cilta-cel), a chimeric antigen receptor T (CAR-T) cell therapy with 2 B-cell maturation antigen (BCMA)–targeting single-domain antibodies, led to early, deep, and durable responses in the phase 1b/2 CARTITUDE-1 study (NCT03548207) in heavily pretreated patients (pts) with relapsed/refractory multiple myeloma (RRMM). At ̃1-year (y) median follow-up (MFU), overall response rate (ORR) was 97%; 67% of pts achieved stringent complete response (sCR). 1-y progression-free survival (PFS) and overall survival (OS) rates were 77% and 89%, respectively (Berdeja 2021). Updated results 2-y post last patient in (LPI) will be presented (̃30-month total MFU). Here, we report CARTITUDE-1 results at 21.7-month MFU. Methods: Eligible pts with RRMM received ≥3 prior lines of therapy (LOT) or were refractory to a proteasome inhibitor (PI) and immunomodulatory drug (IMiD) and had received a PI, IMiD, and anti-CD38 antibody. Bridging therapy was permitted after apheresis. Pts received a single cilta-cel infusion (target dose 0.75×106 CAR+ viable T cells/kg) 5–7 days after lymphodepletion. Primary objectives were to evaluate cilta-cel safety and efficacy. Response was assessed per International Myeloma Working Group criteria by independent review committee and minimal residual disease (MRD) negativity at 10-5 by next-generation sequencing. Results: As of July 22, 2021, 97 pts (59% male; median age 61 y) received cilta-cel. Pts had a median of 6 (range 3–18) prior LOT; 84% were penta-drug exposed, 88% were triple-class refractory, 42% were penta-drug refractory, and 99% were refractory to last LOT. ORR was 97.9% (95% CI 92.7–99.7), 94.9% achieved very good partial response, and 82.5% achieved sCR. Median times to first response, best response, and ≥CR were 1.0, 2.6, and 2.9 months (m), respectively; median duration of response was not reached (NR). Of 61 pts evaluable for MRD, 92% were MRD negative (10-5), sustained for ≥6 m in 44% (27/61) and ≥12 m in 18% (11/61). 2-y PFS was 60.5% (95% CI 48.5–70.4). Median PFS and OS were NR. 2-y PFS rates in pts with sustained MRD negativity for ≥6 m and ≥12 m were 91% and 100%, respectively. There were no new safety signals or new events of CAR-T cell neurotoxicity, movement and neurocognitive treatment-emergent adverse events, or treatment-related deaths since 1-y MFU. 15 second primary malignancies were reported in 11 pts over ̃2-y MFU. Conclusions: At ̃2-y MFU, a single cilta-cel infusion led to deepening and durable responses in heavily pretreated pts with RRMM with a manageable safety profile. Follow-up is ongoing, and landmark 2-y post LPI data (̃8 m additional follow-up; ̃30 m total MFU) will be presented. Further investigations of cilta-cel are ongoing in earlier LOT and outpatient settings across the CARTITUDE program (NCT04133636, NCT04181827, NCT04923893). Clinical trial information: NCT03548207.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT03548207

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 8028)

DOI

10.1200/JCO.2022.40.16_suppl.8028

Abstract #

8028

Poster Bd #

452

Abstract Disclosures