Omar Castaneda Puglianini, MD, hematologist and medical oncologist, Moffitt Cancer Center, discusses next steps with CAR T-cell therapy in penta-refractory multiple myeloma.

The FDA-approved CAR T-cell therapy idecabtagene vicleucel (ide-cel; Abecma) and the investigational product ciltacabtagene autoleucel (cilta-cel)have demonstrated utility in the treatment of patients with heavily pretreated multiple myeloma. However, it is important to improve upon the duration of response (DOR) observed with these regimens, Castaneda Puglianini says. Moreover, novel strategies are being examined, as is the role of maintenance therapy patients who progress on CAR T-cell therapy in terms of prolonging DOR, Castaneda Puglianini notes.

Also, developments are being made regarding how to sequence therapies, such as bispecific antibodies or antibody-drug conjugates targeting antigens beyond BCMA, in the post–CAR T-cell therapy space, Castaneda Puglianini continues. These are all areas in need of further examination to improve patient responses, especially in individuals with penta-refractory or triple-class refractory disease who currently have poor overall survival, Castaneda Puglianini concludes.

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Omar Castaneda Puglianini, MD, hematologist and medical oncologist, Moffitt Cancer Center, discusses next steps with CAR T-cell therapy in penta-refractory multiple myeloma. 


Dr. Castaneda Puglianini on Next Steps With CAR T-Cell Therapy in Multiple Myeloma

Omar Castaneda Puglianini, MD, hematology and medical oncologist at Moffitt Cancer Center, discusses results from the phase 1b/2 CARTITUDE-1 trial (NCT03548207) evaluating ciltacabtagene autoleucel (cilta-cel) in patients with relapsed/refractory multiple myeloma. 

Results from the study showed that the overall response rate (ORR) was 97.9%, Castaneda Puglianini says. With longer follow-up, responses to the CAR T-cell therapy deepened. The stringent complete response (sCR) rate increased from 67% at a median follow-up of 8 to 9 months, to 80.4% at 18 months, Castaneda Puglianini notes.

The median duration of response with the agent was 21.8 months, and the median progression-free survival (PFS) was 22.8 months, Castaneda Puglianini adds. Notably, for patients who achieved a sCR, the median PFS was not reached. Response rates were also comparable across patient subgroups, including those who received previous lines of therapy and extramedullary disease. Overall, the efficacy demonstrated by cilta-cel on this study was impressive, Castaneda Puglianini concludes.

Omar Castaneda Puglianini, MD, discusses results from the phase 1b/2 CARTITUDE-1 trial evaluating ciltacabtagene autoleucel in patients with relapsed/refractory multiple myeloma. 

Omar Castaneda Puglianini, MD

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Dr. Castaneda Puglianini on Next Steps With CAR T-Cell Therapy in Multiple Myeloma

Dr. Castaneda Puglianini on Outcomes With Cilta-Cel in Relapsed/Refractory Myeloma