Moffitt Cancer Center has the largest multiple myeloma program in Florida and is world-renowned for its expertise in tackling this hematologic malignancy. Multiple myeloma remains incurable for roughly 85% of patients, making the challenge of finding new treatments and curative intent strategies all the more urgent. Moffitt is at the forefront of these discoveries through ongoing research efforts and the provision of cutting-edge therapies to patients in need, such as commercially approved CAR (chimeric antigen receptor) T-cell therapy.
In March of 2021, the FDA approved idecabtagene vicleucel (ide-cel, Abecma) as the first B-cell maturation antigen (BCMA)-directed CAR T-cell therapy for treating relapsed or refractory multiple myeloma. This was followed in February 2022 by ciltacabtagene autoleucel (cilta-cel, Carvykti) CAR T-cell therapy.
Studies show that CAR T-cell therapy has a >70% response rate among patients with multiple myeloma and can lead to a complete response. Moffitt has treated more than 100 multiple myeloma patients with approved CAR T-cell therapies, and is one of the highest volume providers globally.
Doris Hansen, MD, Assistant Member in the Department of Blood and Marrow Transplant and Cellular Immunotherapy, explains, “Most patients appear to benefit from ide-cel, and data is showing there are steps we can take to enhance its safety and efficacy for patients with multiple myeloma.”
In late 2021, Dr. Hansen established the Multiple Myeloma Cellular Therapy Consortium, an alliance of 15 CAR T-cell therapy programs nationwide, with 3 more expected to join soon. Consortium members are dedicated to sharing data across institutions to expedite scientific breakthroughs. By pooling data, the Consortium has created the largest cohort of multiple myeloma patients treated with CAR T-cell therapy and produced the first multi-center data related to real-world outcomes.
“The ultimate goal of the Consortium and the large clinical database we’ve created is to contribute to a better understanding of the efficacy and safety of novel adoptive cellular therapies for multiple myeloma,” notes Dr. Hansen.
Dr. Hansen presented findings related to the real-world experience of treating multiple myeloma patients with ide-cel CAR T-cell therapy at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting and the 2022 International Myeloma Society (IMS) meeting. Dr. Hansen noted comparable efficacy and toxicity with ide-cel among real-world patients as compared to the pivotal KarMMa trial, even though 75% of patients in the study cohort would not have met KarMMa eligibility criteria. Dr. Hansen also presented data on ide-cel outcomes in patients who have previously received BCMA-targeted therapy, a critical unanswered question in the field. The Consortium data indicated that prior exposure to BCMA-targeted therapy and high-risk cytogenetics were independent predictors of inferior treatment outcomes.
Active projects for the Multiple Myeloma Cellular Therapy Consortium include:
- Investigating outcomes by race and ethnicity
- Prior exposure to BCMA-targeted therapy
- CAR T for patients with renal insufficiency
The Consortium and Moffitt team have several abstracts selected for presentation at upcoming national meetings, pending publications, and funded research projects.
“There are certainly a lot of exciting areas of research through Moffitt and the Multiple Myeloma Cellular Therapy Consortium,” said Dr. Hansen, “and we look forward to sharing the latest at the American Society of Hematology (ASH) Annual Meeting next month.”