Dr. Cohen on the Efficacy of Cilta-Cel in Lenalidomide-Refractory Multiple Myeloma

Adam D. Cohen, MD, assistant professor of medicine, director, Myeloma Immunotherapy, University of Pennsylvania, discusses the efficacy of ciltacabtagene autoleucel (cilta-cel; Carvykti) in patients with lenalidomide-refractory multiple myeloma.

Cohort A of the phase 2 CARTITUDE-2 trial (NCT04133636) evaluated cilta-cel to determine the minimal residual disease (MRD)–negativity rate in patients with relapsed/refractory multiple myeloma who received 1-3 prior lines of therapy, including a proteasome inhibitor and immunomodulatory therapy. Patients were required to be lenalidomide (Revlimid) refractory.

Findings presented at the 19th Annual International Myeloma Society Meeting showed that 20 of the 25 patients enrolled in cohort A received treatment with cilta-cel, Cohen says. The median number of prior lines of therapy was 2, all patients were lenalidomide refractory, 40% were triple-class refractory, 60% were refractory to daratumumab (Darzalex), and 85% received prior stem cell transplant, Cohen adds.

Treated patients achieved an overall response rate of 95%, including a complete response rate of 90%, Cohen continues. The primary end point of the trial is MRD negativity, and in Cohort A, all 16 evaluable patients were MRD negative, Cohen adds. 

At the data cutoff of 17 months, the median duration of response has not been reached, and approximately 90% of the responders were still in response at 12 months or more, Cohen explains. Additionally, the estimated 15-month progression-free survival rate was approximately 70%. The efficacy data have been positive, though longer follow-up is needed, Cohen concludes.