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Multiple myeloma is a rare blood cancer that accounts for roughly 1% of all hematologic malignancies globally. It is difficult to treat with poor outcomes, but cell therapy is proving to be a viable option for this patient population.

New clinical trial data presented at the American Society of Clinical Oncology Annual Meeting showed ciltacabtagene autoleucel, a chimeric antigen receptor T-cell therapy (CAR T), provided a higher overall response rate and reduced risk of disease progression when compared to two standard of care therapies. The CARTITUDE-4 phase 3 study randomized 419 patients into CAR T or standard of care arms. Patients in the standard of care arm were treated with the physician’s choice of pomalidomide, bortezomib and dexamethasone or daratumumab, pomalidomide and dexamethasone. The CAR T arm received ciltacabtagene autoleucel.

Results found that ciltacabtagene autoleucel was superior to standard of care, providing a 12-month progression free survival rate of 76% compared to 49%. Overall response to the therapy was also higher in the CAR T arm, 85% to 67% respectively.

headshot of Dr. Brandon Blue

Dr. Brandon Blue, Malignant Hematology Department

The U.S. Food and Drug Administration approved ciltacabtagene autoleucel for the treatment of multiple myeloma in February 2022. It is indicated for patients with relapsed and/or refractory disease who have failed four or more lines of therapy. However, CARTITUDE-4 investigators believe their phase 3 results could be a good case for providing the cellular therapy earlier, possibly after a patient’s first relapse.

“This study is a game changer for our multiple myeloma patients. Currently, we are seeing good results for patients with CAR T, however, it isn’t approved until patients have had several disease relapses,” said Dr. Brandon Blue, medical oncologist in Moffitt Cancer Center’s Department of Malignant Hematology. “This study is important because we get to see excellent results but now for patients at much earlier in their disease course.”