Mounzer Agha, MD, Director of the Mario Lemieux Center for Blood Cancers at UPMC Hillman Cancer Center and Clinical Director of the Hematopoietic Stem Cell Transplantation of UPMC, discusses data of Cohort A of the CARTITUDE-2 study. This study is evaluating ciltacabtagene autoleucel (cilta-cel) as a treatment of lenalidomide refractory multiple myeloma in patients who have received 1 to 3 prior lines of therapy. The lastest data from the study was presented at the 2021 ASCO Annual Meeting.
Multiple myeloma is a blood cancer associated with uncontrolled growth of plasma cells. Abnormal plasma cells – also known as myeloma cells – interfere with the production of healthy blood cells in the bone marrow. Myeloma cells also produce inactive clones of abnormal antibodies that may negatively affect the bones and kidneys. Symptoms of multiple myeloma may include: bone pain (particularly in the chest and spine), frequent infections, weakness or numbness in the legs, fatigue, confusion, excessive thirst, and constipation. While the disease is treatable, relapses are common and some patients are refractory to first line treatment.
As Dr. Agha explains, cilta-cel is a chimeric antigen receptor T (CAR-T)-cell therapy with 2 BCMA-targeting, single-domain antibodies designed to confer high avidity binding. CARTITUDE-2 is a phase 2, multicohort, open-label study assessing the efficacy and safety of cilta-cel in patients with multiple myeloma in various clinical settings. At the 2021 ASCO Annual Meeting, data from cohort A (patients who received 1−3 prior lines of therapy) was announced. This data demonstrated an impressive overall response rate of 95%. CAR T-cell neurotoxicity occurred in 20% of participants (all grade 1/2). Three participants had ICANS (1 grade 1; 2 grade 2); median time to onset was 8 days and median duration was 2 days. One participant had grade 2 facial paralysis that started on day 29 and lasted 51 days. Neurologic adverse events were generally manageable in participants with multiple myeloma following treatment with cilta-cel. With a median follow-up of 5.8 months, there were no movement or neurocognitive disorders in study participants.
To learn more about multiple myeloma, visit our Multiple Myeloma Learning Page.