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Real-world outcomes in relapsed refractory multiple myeloma patients exposed to three or more prior treatments: an analysis from the ANZ myeloma and related diseases registry.
Lim, Sueh-Li; Wellard, Cameron; Moore, Elizabeth; Harrison, Simon J; Hang, Quach; Ho, Joy; Rajagopal, Rajeev; Spencer, Andrew.
Afiliación
  • Lim SL; Clinical and Translational Myeloma, Alfred Health, Melbourne, Victoria, Australia.
  • Wellard C; Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria, Australia.
  • Moore E; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Harrison SJ; Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Hang Q; Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Ho J; St. Vincent's Hospital, Melbourne, Victoria, Australia.
  • Rajagopal R; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
  • Spencer A; Middlemore Hospital, Auckland, New Zealand.
Intern Med J ; 54(5): 773-778, 2024 May.
Article en En | MEDLINE | ID: mdl-38149340
ABSTRACT

BACKGROUND:

There is no currently available standard of care for triple-class exposed, relapsed refractory myeloma (RRMM) patients in Australia. CARTITUDE-1 (CART-1) was a single-arm, phase 1b/2 study of 97 triple-class exposed RRMM patients, who received BCMA-CAR-T cell therapy with ciltacabtagene autocel. Overall response rate (ORR) was 98%. Median progression free survival (PFS) and overall survival (OS) had not been reached at a median follow-up of 28 months.

METHODS:

We performed a retrospective analysis on a cohort of CART-1 comparable RRMM patients participating in the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR), to compare outcomes in triple-class exposed MM patients treated with currently available therapies, in a real-world context. The CE-MRDR cohort (n = 28) fulfilled CARTITUDE-1 eligibility (CE) criteria ≥3 lines of therapy (LOT) including an immunomodulatory agent, proteasome inhibitor and CD38-directed monoclonal antibody (CD38mAb) and Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0-2 at diagnosis. The modified-CE-MRDR (n = 132) received ≥3 LOT but may not have received a CD38mAb with an ECOG PS score of 3 (0-3).

RESULTS:

Responses to the first subsequent therapy after eligibility were poor - ORR was 23% and 0% with progressive disease (PD) reported in 61% and 36%, CE-MRDR and m-CE-MRDR respectively. Responses to the second subsequent therapy after eligibility were worse, ORR 0% and 31%, CE-MRDR and m-CE-MRDR respectively, with high rates of PD, particularly in CE-MRDR. Median OS was 5.4 versus 9.5 months, CE-MRDR versus m-CE-MRDR.

CONCLUSIONS:

This retrospective analysis confirms uniformly poor outcomes for Australian RRMM patients. There remains a critical need for greater accessibility to novel treatments, such as CAR-T, outside clinical trials.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Mieloma Múltiple Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Intern Med J Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Mieloma Múltiple Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Intern Med J Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia