Dr Mohan on CAR T-cell Therapies and Bispecific Antibodies in R/R Multiple Myeloma

Meera Mohan, MD, MS, FACP, assistant professor, hematology, medical oncology, Froedtert & The Medical College of Wisconsin, discusses the significance of CAR T-cell therapies and bispecific antibodies in patients with relapsed/refractory multiple myeloma.

CAR T-cell therapies and bispecific antibodies have expanded the treatment arsenal for patients with relapsed/refractory multiple myeloma, Mohan says. On March 26, 2021, the FDA approved the CAR T-cell therapy idecabtagene vicleucel (ide-cel; Abecma) for use in patients with relapsed/refractory multiple myeloma who had received at least 4 prior lines of therapy. The decision was supported by findings from the phase 2 KarmMMa trial (NCT03361748). On February 28, 2022, the FDA approved ciltacabtageneautoleucel (cilta-cel; Carvykti) for patients with relapsed/refractory disease who had received at least 4 prior lines of therapy, based on data from the phase 1b/2 CARTITUDE-1 trial (NCT03548207). Additionally, on October 25, 2022, the FDA granted accelerated approval to the bispecific antibody teclistamab in patients with relapsed/refractory disease who have received at least 4 prior lines of therapy, backed by findings from the phase 1/2 MajesTEC-1 trial (NCT04557098).

Prior to these FDA approvals, an unmet need existed for effective therapies for patients with triple-class refractory multiple myeloma, Mohan emphasizes. CAR T-cell therapies and bispecific antibodies have generated high and often durable response rates in this population, Mohan explains. For example, in KarMMa, ide-cel generated a 73% overall response rate (ORR), with 19.0-month, 10.4-month, and 4.5-month durations of response (DOR) in patients who achieved a complete response (CR) or stringent CR, those who achieved a very good partial response (PR), and those who achieved a best response of PR, respectively. In CARTITUDE-1, cilta-cel elicited an ORR of 97%, with a median DOR that was not yet reached. In MajesTEC-1, the ORR was 63.0% in patients who received teclistamab, and the median DOR was 18.4 months.

These treatment options have revolutionized the treatment of patients with relapsed/refractory multiple myeloma, Mohan concludes.