Treatment of Relapsed/Refractory Multiple Myeloma with Ciltacabtagene Autoleucel or Idecabtagene Vicleucel in Racial Minorities-a Multicenter Study

• Published in: Blood 2024-11, Vol.144, p.2404-2404
• Main Authors: Chang, Darryl, Habib, Alma, Vegel, Andrew, Struble, Emily, Shaikh, Hira, Strouse, Christopher, Green, Kimberly M, Mushtaq, Muhammad Umair, Mahmoudjafari, Zahra, Hashmi, Hamza, McGuirk, Joseph P., Khan, Abdullah Mohammad, Abdallah, Al-Ola, Ahmed, Nausheen, Atrash, Shebli, Bhutani, Manisha
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-208692

Introduction: Ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) are B-cell maturation antigen-directed chimeric antigen receptor T-cell (CAR-T) therapies which have been shown to be effective treatments for patients with relapsed/refractory multiple myeloma (RRMM). Cilta-cel was shown to have an overall response rate (ORR) of 84.6% in the CARTITUDE-4 trial, while ide-cel was shown to have an ORR of 71% in the KarMMA-3 trial. Patient representation among racial and ethnic minorities has historically been low in clinical trials such as these. Only 2.9% of the patients in CARTITUDE-4 were identified as Black or African American. In the KarMMA-3 trial, only 7% of patients were Black and 3% were Asian. This study sought to evaluate outcomes in racial ethnic minorities compared to White patients. Methods: We conducted a retrospective multicenter analysis of consecutive patients with RRMM who received cilta-cel or ide-cel between May 2022 and April 2024. 5 centers were included in the analysis, including Levine Cancer Institute, Ohio State University, University of Kansas Medical Center, University of Iowa, and Medical University of South Carolina. Response to treatment was assessed using the International Myeloma Working Group (IMWG) criteria. Baseline characteristics, response rates, progression-free survival (PFS), overall survival (OS), and toxicities were compared. Using R Core Team (2024) software, a descriptive analysis was performed. Continuous variables were summarized and reported the mean (min, max) and median (IQR). Dichotomized factors were summarized by total numbers and frequency. Fisher's exact was used to analyze contingency tables. Wilcoxon rank-sum test was used to compare two independent samples. A univariate Cox proportional hazards analysis assessed the relationship between variables and a time-to-event outcome. The analysis calculated hazard ratios (HRs) and associated confidence intervals (CIs) for each predictor variable, adjusting for censoring in survival data. Results: Of the 223 patients who received either cilta-cel or ide-cel for treatment of RRMM, 79% of patients were White, and 21% were racial minorities. The 46 patients who self-reported as racial minorities comprised 2 Asians, 39 Blacks, 2 Hispanics, and 3 patients from other racial groups. Minority patients (MP) were younger at infusion than White patients (WP), with average age 61.3 vs 64.8 years (p = 0.012). 43% of MP were male, vs 59% of WP (p = 0.05