Real-world outcomes in relapsed refractory multiple myeloma patients exposed to three or more prior treatments: an analysis from the ANZ myeloma and related diseases registry

Lim, SL; Wellard, C; Moore, E; Harrison, SJ; Hang, Q; Ho, J; Rajagopal, R; Spencer, A

Author(s): Lim, SL; Wellard, C; Moore, E; Harrison, SJ; Hang, Q; Ho, J; Rajagopal, R; Spencer, A;
Details: Publication Year 2024-05,Volume 54,Issue #5,Page 773-778
Journal Title: Internal Medicine Journal
Publication Type: Research article
Abstract: BACKGROUND: There is no currently available standard of care for triple-class exposed, relapsed refractory myeloma (RRMM) patients in Australia. CARTITUDE-1 (CART-1) was a single-arm, phase 1b/2 study of 97 triple-class exposed RRMM patients, who received BCMA-CAR-T cell therapy with ciltacabtagene autocel. Overall response rate (ORR) was 98%. Median progression free survival (PFS) and overall survival (OS) had not been reached at a median follow-up of 28 months. METHODS: We performed a retrospective analysis on a cohort of CART-1 comparable RRMM patients participating in the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR), to compare outcomes in triple-class exposed MM patients treated with currently available therapies, in a real-world context. The CE-MRDR cohort (n = 28) fulfilled CARTITUDE-1 eligibility (CE) criteria: ≥3 lines of therapy (LOT) including an immunomodulatory agent, proteasome inhibitor and CD38-directed monoclonal antibody (CD38mAb) and Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0-2 at diagnosis. The modified-CE-MRDR (n = 132) received ≥3 LOT but may not have received a CD38mAb with an ECOG PS score of 3 (0-3). RESULTS: Responses to the first subsequent therapy after eligibility were poor - ORR was 23% and 0% with progressive disease (PD) reported in 61% and 36%, CE-MRDR and m-CE-MRDR respectively. Responses to the second subsequent therapy after eligibility were worse, ORR 0% and 31%, CE-MRDR and m-CE-MRDR respectively, with high rates of PD, particularly in CE-MRDR. Median OS was 5.4 versus 9.5 months, CE-MRDR versus m-CE-MRDR. CONCLUSIONS: This retrospective analysis confirms uniformly poor outcomes for Australian RRMM patients. There remains a critical need for greater accessibility to novel treatments, such as CAR-T, outside clinical trials.
Publisher: Wiley
Keywords: Humans; *Multiple Myeloma/drug therapy; Male; Female; Retrospective Studies; Middle Aged; *Registries; Aged; Australia/epidemiology; Immunotherapy, Adoptive; Adult; New Zealand/epidemiology; Treatment Outcome; B-Cell Maturation Antigen/antagonists & inhibitors; Receptors, Chimeric Antigen/therapeutic use
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.1111/imj.16277
Open Access at Publisher's Site: https://doi.org/10.1111/imj.16277
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-11 07:07:10

Last Modified: 2024-07-11 07:07:39