Dose therapy of potentially curative car-T in multiple myeloma

A multi-institutional study led by the Icahn School of Medicine of Mount Sinai reports that a third of patients with multiple relapse or refractory myeloma have remained in remission for at least five years after a single infusion of the therapy by CAR-T Cilta-Cel.

Multiple myeloma is a blood cancer This responds well to initial treatments, but often relapse or becomes resistant. It is particularly difficult to treat in patients who have undergone several previous lines of therapy.

Historical data show Survival without median progression Less than six months and overall survival for almost a year for these people. Ciltacabtagene Autoleucel (Cilta-Cel), a chimerical antigen receiver (CAR) T cell therapy has demonstrated more sustainable responses in the previous monitoring of the Carignae-1 test.

In the study, “long -term remission (≥ 5 years) and survival after treatment with Ciltacabtagene Autoleucel in patients Cartuitude 1 with a multiple relapse / refractory myelome”, ” published In Journal of Clinical OncologyThe researchers carried out a post hoc analysis to assess overall survival, sustained remission, associated immunological biomarkers and safety results after treatment with a single infusion of Cilta-Cel.

In total, 97 patients with multiple relapse or refractory myelome (RRMM), each previously treated with at least three lines of therapy and almost all refractory to Triple Class, received a single Cilta-Cel infusion between July 2018 and October 2019 on several clinical sites.

Survival and progression were followed using Kaplan-Meier methods on median follow-up of 61.3 months. Of the 97 patients, 32 (33% of the cohort) remained alive and without progression five years after the infusion, without maintenance treatment. Almost all (31 of 32) obtained a strict complete response (remission of the disease) by independent review.

In addition, 12 patients in a single center underwent serial assessments and were a negative minimum residual disease and negative imagery in the fifth year or later.

Patients who have remained without progression have shown trends towards a lower tumor load, a higher hemoglobin and platelets at the start and higher proportions of naive T cells in the infused product. They also had higher effective / target relationships and greater peak expansion of car-positive T cells, as well as more favorable relationships of T / Neuutrophil cells.

Security has remained consistent with previous reports, without new cases of parkinsonism or heads of heads. Among long -term respondents, two primary malignant tumors, two neurological events and four or more grade 3 infections were reported.

Investigators describe these results as the longest follow-up reported for CAR-T therapy in several myeloma To date and interpret them as proof of potentially curative results in a subset of patients.

Clinical trials are underway to assess Cilta-Cel in previous treatment lines, in order to expand long-term survival and without treatment to more patients.

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