Real-World Impact of Bridging Therapy on Outcomes of Ide-cel for Myeloma in the U.S. Myeloma Immunotherapy Consortium

Author:

Afrough Aimaz1,Hashmi Hamza2,Hansen Doris3ORCID,Sidana Surbhi4ORCID,Ahn Chul1,Peres Lauren3ORCID,Dima Danai5ORCID,Freeman Ciara3,Puglianini Omar Castaneda3ORCID,Kocoglu Mehmet6,Atrash Shebli7,Voorhees Peter8,Shune Leyla9,McGuirk Joseph10ORCID,Simmons Gary11,Sborov Douglas12ORCID,Davis James2ORCID,Kaur Gurbakash1ORCID,Sannareddy Aishwarya1,Ferreri Christopher13ORCID,Gaballa Mahmoud14,Janakiram Murali15,nadeem omar16,Midha Shonali16,Wagner Charlotte12ORCID,Locke Frederick3,Patel Krina14ORCID,Khouri Jack5,Anderson Larry17ORCID,Lin Yi18ORCID

Affiliation:

1. UT Southwestern Medical Center

2. Medical University of South Carolina

3. H. Lee Moffitt Cancer Center and Research Institute

4. Stanford University

5. Cleveland Clinic

6. University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center

7. Levine Cancer Institute-Morehead (Hematology)

8. Levine Cancer Institute, Atrium Health

9. Division of Hematologic Malignancies and Cellular Therapeutics (HMCT), University of Kansas Medical Center

10. University of Kansas Medical Center

11. Virginia Commonwealth University Massey Cancer Center

12. Huntsman Cancer Institute, University of Utah

13. UT MD Anderson Cancer Center

14. The University of Texas MD Anderson Cancer Center

15. City of Hope

16. Dana Farber

17. UT Southwestern

18. Mayo Clinic

Abstract

Abstract In a retrospective analysis at 11 US medical centers, bridging therapy (BT) impact after receiving idecabtagene vicleucel was assessed in 214 patients. 79% received BT, including 12% Selinexor-containing, 45% alkylator-based, 15% proteasome inhibitor combinations, and 18% immunomodulatory drugs +/- monoclonal antibody combinations (IMiD +/- mAb combos). BT recipients had worse performance status, higher stage disease, ferritin and CRP pre-infusion. The overall response rate to BT was 12%, with no difference among BT subgroups. Safety profiles were similar, but Selinexor had a higher grade ≥2 ICANS incidence. Median progression-free survival (PFS) was 6.7 months in BT vs. 11.5 months in no-BT (p=0.007). Median PFS was longest with IMiD +/- mAb combos (12 months), comparable to no-BT, and significantly longer than other BT subgroups (p=0.01). Alkylator-based BT had inferior PFS compared to IMiD +/- mAb combos (p=0.03). Median overall survival (OS) for the BT was 13.8 months vs. not reached in no-BT (p=0.002). Alkylator-based BT had shorter OS compared to others (11.97 months vs. NR; p=0.001). Stepwise Cox regression showed alkylator-based BT and response

Publisher

Research Square Platform LLC

Reference12 articles.

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2. Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma;Munshi NC;N Engl J Med,2021

3. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells;Lee DW;Biol Blood Marrow Transplant,2019

4. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0: U.S. Department of Health and Human Services; November 2017 [Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf.

5. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma;Kumar S;Lancet Oncol,2016

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