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Access through your institution Buy or subscribe Two successful phase 3 clinical trials of B cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T cells suggest that such
agents could be used earlier in the treatment of patients with relapsed and/or refractory multiple myeloma, for which many effective treatments are available but no standard of care exists.
Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) had previously shown efficacy in heavily pre-treated patients with relapsed or treatment-refractory multiple
myeloma. The present studies demonstrate similar benefits for these CAR T cell therapies in patients who had received fewer pre-treatments. In the CARTITUDE-4 study, cilta-cel conferred a
reduced risk of disease progression or death versus physician’s choice of care (two regimens) in patients with lenalidomide-refractory disease who had received 1–3 previous therapies.
Progression-free survival at 12 months was 75.9% (95% confidence interval (CI) 69.4–81.1%) in the cilta-cel group versus 48.6% (95% CI 41.5–55.3%) in the standard-care group. The rates of
overall response (84.6% versus 67.3%), complete response (73.1% versus 21.8%) and absence of minimal residual disease (60.6% versus 15.6%) all favoured cilta-cel. Similarly, in the KarMMa-3
trial, ide-cel conferred a decreased risk of disease progression or death (hazard ratio 0.49, 95% CI 0.38–0.65, at a median 18.6 months of follow-up), as well as improved treatment response
rates (71% versus 42%) and complete response rates (39% versus 5%) versus physician’s choice of care (five regimens) in patients who had received 2–4 previous therapies of ≥3 classes. No new
safety concerns were raised: rates of cytokine release syndrome (CRS) were 88% (5% grade ≥3) with ide-cel and 76.1% (1.1% grade ≥3) with cilta-cel; neurotoxicity rates were 15% (3% grade
≥3) with ide-cel and 4.5% (none grade ≥3) with cilta-cel. This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Access Nature
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INFORMATION AUTHORS AND AFFILIATIONS * Nature Cancer https://www.nature.com/natcancer/ Caroline Barranco Authors * Caroline Barranco View author publications You can also search for this
author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Caroline Barranco. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Barranco, C. CAR
T cell therapy for multiple myeloma. _Nat Cancer_ 4, 1644 (2023). https://doi.org/10.1038/s43018-023-00680-2 Download citation * Published: 15 December 2023 * Issue Date: December 2023 *
DOI: https://doi.org/10.1038/s43018-023-00680-2 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is
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