Abstract
Efficacy and safety of ciltacabtagene autoleucel ± lenalidomide maintenance in newly diagnosed multiple myeloma with suboptimal response to frontline autologous stem cell transplant: CARTITUDE-2 cohort D.
Author
person
Bertrand Arnulf
Saint-Louis Hospital, APHP, University Paris Cité, Paris, France
info_outline
Bertrand Arnulf, Tessa Kerre, Mounzer E. Agha, Michel Delforge, Ira Braunschweig, Nishi Shah, Shambavi Richard, Melissa Alsina, Hermann Einsele, Pankaj Mistry, Helen Varsos, Christina Corsale, Jordan Mark Schecter, Kevin C. De Braganca, Yogesh Jethava, Qingxuan Song, Mythili Koneru, Muhammad Akram, Yaël C Cohen, Wilfried Roeloffzen
Full text
Authors
person
Bertrand Arnulf
Saint-Louis Hospital, APHP, University Paris Cité, Paris, France
info_outline
Bertrand Arnulf, Tessa Kerre, Mounzer E. Agha, Michel Delforge, Ira Braunschweig, Nishi Shah, Shambavi Richard, Melissa Alsina, Hermann Einsele, Pankaj Mistry, Helen Varsos, Christina Corsale, Jordan Mark Schecter, Kevin C. De Braganca, Yogesh Jethava, Qingxuan Song, Mythili Koneru, Muhammad Akram, Yaël C Cohen, Wilfried Roeloffzen
Organizations
Saint-Louis Hospital, APHP, University Paris Cité, Paris, France, Ghent University Hospital, Ghent, Belgium, UPMC Hillman Cancer Center, Pittsburgh, PA, University of Leuven, Leuven, Belgium, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, Montefiore Medical Center, Bronx, NY, Icahn School of Medicine at Mount Sinai, New York, NY, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany, Johnson & Johnson Innovative Medicine, High Wycombe, United Kingdom, Johnson & Johnson Innovative Medicine, Raritan, NJ, Legend Biotech USA Inc., Somerset, NJ, Tel Aviv Sourasky (Ichilov) Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, University Medical Center Groningen, Groningen, Netherlands
Abstract Disclosures
Research Funding
Johnson & Johnson Innovative Medicine
Legend Biotech USA Inc.
Background:
CARTITUDE-2 is a phase 2 multicohort study evaluating ciltacabtagene autoleucel (cilta-cel) across various clinical settings. Cohort D is evaluating cilta-cel ± lenalidomide (len) maintenance in patients (pts) with newly diagnosed multiple myeloma (NDMM) who achieved less than complete response (CR) after autologous stem cell transplant (ASCT) frontline therapy (tx). We report efficacy and safety for this cohort.
Methods:
Adults with NDMM per IMWG criteria, best response of <CR and ≥stable disease after 4–8 cycles of initial tx, including induction, high-dose chemotherapy and ASCT ± consolidation, and without exposure to CAR-T or anti-BCMA tx received a single cilta-cel infusion (target dose, 0.75×106 CAR+ viable T cells/kg) 5–7 d after the start of lymphodepletion. Per protocol, safety was assessed in the first 5 pts with cilta-cel only; subsequently, 12 pts initiated continuous len maintenance ≥21 d post cilta-cel for ≤2 yrs. Primary endpoint was minimal residual disease negativity (MRD neg) at 10–5 based on next-generation sequencing or flow.
Results:
As of Sept 5, 2023 (median follow-up, 22 mo [range, 5–39]), 17 pts received cilta-cel (with len, n=12; without len, n=5). Median age was 54 yrs; 6% had high-risk cytogenetics; and 100% were International Staging System stage I at baseline. Of 15 MRD-evaluable pts, 12 (80%) achieved MRD neg at 10–5; median time to MRD neg was 1 mo (range, 1–6). Overall response rate was 94% (n=16/17; ≥CR, 94%). Median duration of response was not reached, and median time to first response was 1 mo. Progression-free survival (investigator-assessed) and overall survival rates at 18 mo were 94% each. CAR+ T cells peaked in blood at a median of 12 d post infusion (mean, 2187 cells/µL; SD, 2102 cells/µL) and remained detectable for a median of 43 d (range, 26–209). All pts had grade (gr) 3/4 TEAEs. Hematologic TEAEs included neutropenia (94%), lymphopenia (65%), thrombocytopenia (47%), and leukopenia (41%). Infections occurred in 12 (71%) pts (gr 3/4, 29%). CRS occurred in 14 (82%) pts, and median time to onset was 8 d. All CRS events were gr 1/2 and recovered in a median of 3 d. ICANS occurred in 1 pt (gr 1); median time to onset was 7 d and recovery was 1 d. Other neurotoxicities occurred in 6 pts (gr 1, n=1; gr 2, n=4; gr 3, n=1); median time to onset was 21 d and recovery was 70 d (n=4). No MNTs/parkinsonism occurred. 1 pt had a secondary malignancy of gr 3 MDS with an onset on d 353 that was not treatment related per investigator assessment.
Conclusions:
In pts with NDMM and <CR after frontline ASCT, a single cilta-cel infusion ± len maintenance demonstrated deep responses that were durable. TEAEs were consistent with the known safety profile of cilta-cel. These data show promising efficacy and safety with cilta-cel ± len maintenance in pts with NDMM who achieved <CR after ASCT frontline tx. Clinical trial information: NCT04133636.
Clinical status
Clinical
1 clinical trial
44 organizations
3 drugs
2 targets
Organization
Saint-Louis HospitalOrganization
APHPOrganization
University Paris CitéOrganization
Paris and Saint CloudOrganization
FranceOrganization
Ghent University HospitalOrganization
BelgiumOrganization
UPMC Hillman Cancer CenterOrganization
Pittsburgh, PAOrganization
PainReformOrganization
University of LeuvenOrganization
Leuven Cancer InstituteOrganization
New BrunswickOrganization
NJOrganization
Bronx, NYOrganization
Nykode TherapeuticsOrganization
New York CityOrganization
TampaOrganization
Flare TherapeuticsOrganization
GermanyOrganization
Johnson & Johnson Innovative Medicine, RaritanOrganization
Legend Biotech USA Inc.Organization
SomersetOrganization
Tel Aviv UniversityOrganization
IsraelOrganization
University Medical Center GroningenOrganization
GroningenOrganization
Netherlands Cancer InstituteOrganization
Tel Aviv Sourasky (Ichilov) Medical CenterOrganization
Sackler Faculty of Medicine, Tel Aviv UniversityOrganization
Sackler Faculty of MedicineOrganization
Universitätsklinikum WürzburgOrganization
Medizinische Klinik und Poliklinik IIOrganization
WürzburgOrganization
High WycombeOrganization
Raritan, NJDrug
cilta-celDrug
lenalidomideTarget
lenalidomideTarget
BCMA×CD3Clinical trial
A Phase 2, Multicohort Open-Label Study of JNJ-68284528, a Chimeric Antigen Receptor T Cell (CAR-T) Therapy Directed Against BCMA in Subjects With Multiple MyelomaStatus: Active (not recruiting), Estimated PCD: 2025-05-30