Ide-cel superior to standard therapies in triple-class-exposed RRMM

Idecabtagene vicleucel (ide-cel) outperformed standard regimens in patients with triple class-exposed relapsed and refractory multiple myeloma (RRMM). The results of the phase 3 KarMMa-3 study supported the use of ide-cel in this hard-to-treat population.

“Novel therapies are needed in earlier lines of treatment for patients with MM,” stated Dr Paula Rodríguez-Otero (Clinica Universidad de Navarra, Spain) [1]. “The BCMA-directed CAR T-cell therapy ide-cel has displayed promising efficacy in a heavily pretreated population of patients with RRMM and we aimed to study this agent in earlier lines of therapy” [1,2]. The phase 3 KarMMa-3 trial (NCT03651128) compared ide-cel with standard treatment regimens in patients with triple class-exposed RRMM who had received 2 to 4 prior lines of therapy and were refractory to the last treatment regimen (n=386). The participants were randomised 2:1 to ide-cel or standard treatment. Progression-free survival (PFS) was the primary endpoint.

The median PFS was significantly longer in patients who received ide-cel compared with those who received a standard regimen (13.3 months vs 4.4 months; HR 0.49; 95% CI 0.38–0.65; P<0.0001). “This result was consistent across subgroups, including older patients, those with a high tumour burden, and patients with high-risk cytogenetic abnormalities,” added Dr Rodríguez-Otero. Finally, the safety data were consistent with the ide-cel toxicity profile reported in previous studies [1,3].

In conclusion, the findings of the KarMMa-3 trial support the use of ide-cel in patients with early-line relapse and triple class-exposed RRMM.

1. 1. Rodriguez-Otero P, et al. Idecabtagene vicleucel versus standard regimens in patients with triple-class-exposed relapsed and refractory multiple myeloma: KarMMa-3, a phase 3 randomized controlled trial. GS02-10, European Society for Blood and Marrow Transplantation (EBMT) 49^th Annual Meeting, 23–26 April 2023, Paris, France.
   2. Munshi NC, et al. N Engl J Med 2021;384:705–716.
   3. Raje N, et al. N Engl J Med 2019;380:1726–1737.

 

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Posted on 2 May, 202314 May, 2023