Most Myeloma Patients Not Eligible for CAR-T in Real-World Setting

 In 2021, the FDA approved idecabtagene vicleucel (ide-cel; Abecma), the first chimeric antigen receptor (CAR) T-cell therapy for patients with relapsed/refractory multiple myeloma.

At the American Society of Hematology (ASH) annual meeting, researchers presented findings on what proportion of real-world myeloma patients, particularly older adults, would be eligible for this treatment.

In the video, courtesy of the Video Journal of Hematological Oncology (VJHemOnc), Luciano Costa, MD, PhD, of the University of Alabama at Birmingham, comments on the data.

Following is a transcript of his remarks:

So at this meeting, my colleague, Dr. Smith Giri, is presenting a very interesting paper in the format of an abstract. He used the Flatiron Health Electronic Health Record database with literally thousands of patients throughout the United States, both in the academic setting and the community setting. And he asked the question, how often are people likely to achieve the current indication for the CAR T-cell therapy that we have approved, which is ide-cel. And just to remind your audience that approval by the FDA is [after] four prior lines of therapy.

And what we learned is pretty concerning, that less than 15% of the patients reach that fourth line of therapy and are able to receive subsequent therapy. Most patients die from disease progression before getting to that point. And that proportion is even lower among the patients who are 70 or older, who are the vast majority of the myeloma patients.

So I think that should shed some light on the real-world applicability of CAR T-cell therapy and also the need to generate information, clinical information, on the use of such an impressive resource, in earlier lines of therapies as well in populations that are often not represented in clinical trials, particularly patients with renal dysfunction or other important comorbidities.

https://www.medpagetoday.com/meetingcoverage/ashvideopearlsmm/96675