Updated phase I study results of PHE885, a T-Charge manufactured BCMA-directed CAR-T cell therapy, for patients (pts) with r/r multiple myeloma (RRMM).

Authors

null

Adam Samuel Sperling

Dana-Farber Cancer Institute, Boston, MA

Adam Samuel Sperling , Benjamin Avi Derman , Sarah Nikiforow , Soo-Yeon Im , Shuntaro Ikegawa , Rao H. Prabhala , Diego Hernandez Rodriguez , Yifang Li , David S. Quinn , David Pearson , Dexiu Bu , Jennifer Mataraza , Jessica Liegel , Anita D'Souza , Lawrence Rispoli , Marc Credi , Jerome Ritz , Andrzej J. Jakubowiak , Serena De Vita , Nikhil C. Munshi

Organizations

Dana-Farber Cancer Institute, Boston, MA, University of Chicago, Chicago, IL, Novartis Institutes for BioMedical Research, Cambridge, MA, Novartis Institutes for BioMedical Research, Basel, Switzerland, Beth Israel Deaconess Medical Center, Boston, MA, Medical College of Wisconsin, Milwaukee, WI

Research Funding

Pharmaceutical/Biotech Company
Novartis

Background: B cell maturation antigen (BCMA) targeted CAR-T cells are approved for RRMM. Long manufacturing time and high clinical demand limit access. T-Charge, an innovative platform that reduces manufacturing time to <2 days and preserves T cell stemness, results in robust expansion and prolonged CAR T cell persistence. Here we report updated results from the Phase I trial of T-Charge manufactured, fully human, BCMA CAR-T PHE885 (NCT04318327). Methods: Eligible pts had RRMM after ≥2 prior lines of therapy (tx). Pts received fludarabine and cyclophosphamide (or bendamustine) for lymphodepletion (LD) prior to PHE885 infusion. Primary objective was safety. Secondary objectives were clinical response and cellular kinetics. Results: As of December 22, 2022, 46 pts received PHE885 at the following doses: 2.5e6 (n=4), 5e6 (n=13), 10e6 (n=20), 14.3e6 (n=1), and 20e6 (n=8) CAR T cells. PHE885 was manufactured for 61% of pts at a single academic institution; these pts proceeded from apheresis to LD in a median of 16 days. Median age at enrollment was 65 y (range [R] 45-81), median prior lines of tx was 4 (R 2-10). 37% of pts had extramedullary disease; 96% were triple refractory. Despite aggressive disease, only 28% of pts required bridging chemotherapy, predominantly influenced by quick production time. 96% of pts experienced any gr cytokine release syndrome (CRS); 11% had gr 3 CRS. Median time to CRS onset was 8 (R 2-16) days and median duration was 4 (R 1-19) days. Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 22% of pts; 7% had gr 3 ICANS. Dose limiting toxicities were experienced by 13% of pts and included gr 4 neutropenia, gr 4 lipase increase, gr 3 serum amylase increase, gr 3 neurotoxicity, gr 3 transaminitis, and gr 3 ejection fraction reduction. The most common tx-related gr ≥3 AEs included anemia (54%), neutropenia (50%), and thrombocytopenia (37%). Geo-mean peak PHE885 expansion (Cmax) was 276,000 copies/µg by qPCR and 70.6% of CD3+ T cells by flow cytometry (n=41). The PHE885 transgene was detected in 13/14 (93%) pts at 6 mo and 5/7 (71%) at 12 mo post infusion. T cells with early memory phenotype were preserved in the final product and persisted in pts post infusion. In 43 efficacy-evaluable pts, the ORR was 98%. At 10e6 dose (n=19), ORR was 100% and CRR was 42% (median follow-up of 4.9 mo [R 1.4-11.8]); 60% of 10 evaluable pts were MRD negative at 10-5 by NGS. Initial efficacy data at 20e6 and longer follow-up at active doses will also be presented. Conclusions: T-Charge manufactured PHE885 produced high response rates with no unexpected safety findings in heavily pretreated RRMM pts with aggressive disease. PHE885 expanded rapidly and showed durable persistence in vivo. Since conversion to CR/sCR has occurred as late as 18 months after infusion in this study, longer follow-up is ongoing to identify a recommended dose for future development. Clinical trial information: NCT04318327.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT04318327

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 8004)

DOI

10.1200/JCO.2023.41.16_suppl.8004

Abstract #

8004

Abstract Disclosures