Dr Lin on the Outcomes of MRD-Negative Patients With R/R Myeloma After Cilta-Cel

Yi Lin, MD, PhD, a hematologist and oncologist in the Department of Hematology and a member of the CAR T-Cell Therapy Program at Mayo Clinic, discusses the patient characteristic for those with relapsed/refractory multiple myeloma who experienced sustained minimal residual disease (MRD) negativity following treatment with ciltacabtagene autoleucel (cilta-cel; Carvykti) during the phase 1/2 CARTITUDE-1 trial (NCT03548207).

Prior findings from CARTITUDE-1 supported the FDA approval of cilta-cel for the treatment of adult patients with relapsed/refractory multiple myeloma following 4 or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Data from the final analysis of the study presented at the 2023 EHA Congress showed that in all patients (n = 97), the 30-month progression-free survival (PFS) rate was 54.2%. In those who experienced sustained MRD negativity for at least 12 months (n = 26), the 30-month PFS rate was 74.9%. 

Investigators then examined the efficacy outcomes and patient characteristics for those with sustained MRD negativity in an analysis presented at the 2023 SOHO Annual Meeting. Lin notes that patients who were evaluable for MRD were sorted into 3 groups for the analysis: those who experienced MRD negativity for less than 6 months, those who sustained MRD negativity for least 6 and but no more than 12 months, and those who achieved MRD negativity for at least 12 months.

All patients who sustained MRD negativity for at least 6 months experienced a stringent complete response (sCR), Lin says, adding that half of the patients who had sustained MRD negativity for less than 6 months achieved a sCR. Longer durations of response were observed in those who sustained MRD negativity for at least 6 months, and within that subgroup, the median PFS has not yet been reached, Lin concludes.