Dr. Munshi on Next Steps With Idecabtagene Vicleucel in R/R Multiple Myeloma

Nikhil C. Munshi, MD, director of Basic and Correlative Science with the Jerome Lipper Multiple Myeloma Center, Kraft Family Chair, and a senior physician with Dana-Farber Cancer Institute, as well as a professor of medicine at Harvard Medical School, discusses the next steps for research with idecabtagene vicleucel (ide-cel; bb2121) in relapsed/refractory multiple myeloma.

Results from the KarMMa study showed that the CAR T-cell therapy induced deep, durable responses in heavily pretreated patients with relapsed/refractory disease. Now, investigators must determine what to do next with these data, Munshi says. The product has proven to be very effective in later lines of therapy and achieving minimal residual disease (MRD) negativity in patients that it makes sense to move idecabtagene vicleucel earlier on in the treatment journey, says Munshi.

Studies further examining the CAR T-cell therapy are already ongoing. For example, the agent is being examined earlier on in high-risk patients. Another study is comparing the use of idecabtagene vicleucel with transplant. The purpose of transplant is to achieve MRD negativity and it is known that this treatment can help patients achieve very deep responses and MRD negativity, says Munshi. The agent is also being looked at as a potential consolidation treatment. The bottom line is that this treatment is going to be further explored in the frontline setting.

Another important point to make is that patients only have to receive 1 infusion. Currently, the data being presented on the therapy is without maintenance, and it is known that maintenance makes a significant difference in myeloma. Now, ongoing studies are starting to treat patients with CAR T and some maintenance treatment with either immunomodulatory agents, checkpoint inhibitors, or other agents that can augment immune function, concludes Munshi.