Outcomes of older adults and frail patients receiving idecabtagene vicleucel: a CIBMTR study
Year: 2024
Type: article
Study design: Observational Study
Abstract: Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy.There is limited data on outcomes of CAR T in older adults and frail patients with RRMM.In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups.An adapted version of the previously described simplified frailty index (SFI) was used to assess frailty.A total of 821 pts were followed for a median of 11.6 months (m, range, 1.1 -26.7 m).Of these patients, 251 (30.6%) were ≥70 years of age.Older adults had higher rates of immune-effector cell associated neurotoxicity syndrome (ICANS) of any grade (37.1% vs 24.2%, p<0.01), but there were no differences in grade ≥3 ICANS or cytokine release syndrome (CRS, any grade or grade≥3).Older adults had improved progression-free survival (PFS) which remained significant in a multivariable model.There was no significant difference in treatment related mortality (TRM).Frail patients (343/766) had a higher rate of ICANS of any grade (37% versus 21.5%, p<0.01) and clinically significant infections (49.6% vs 40.9%, p=0.02), but there were no significant differences in grade ≥3 ICANS, CRS, response, PFS, overall survival or TRM.In conclusion, older adults and frail patients with RRMM had comparable efficacy to younger and non-frail patients, respectively.These patients were at higher risk of developing ICANS but had no increase in other adverse events.
Source: Blood Advances
Authors: Othman Salim Akhtar, Temitope Oloyede, Ruta Brazauskas, Aimaz Afrough, Hamza Hashmi, Surbhi Sidana, Nausheen Ahmed, Matthew Bye, Doris Hansen, Christopher Ferreri, Binod Dhakal, Devender Dhanda, Melanie Harrison, Amani Kitali, Heather Landau, Abu-Sayeef Mirza, Jinalben Patel, Pallavi Patwardhan, Muzaffar Qazilbash, Krina Patel, Taiga Nishihori, Siddhartha Ganguly, Lohith Gowda, Larry D. Anderson, Marcelo C. Pasquini, Saad Usmani, Ciara Louise Freeman
Institutions: Medical College of Wisconsin, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Memorial Sloan Kettering Cancer Center, Stanford Medicine, Stanford University, University of Kansas, The University of Kansas Cancer Center, University of Kansas Medical Center, Moffitt Cancer Center, Atrium Health Wake Forest Baptist, Levine Cancer Institute, Bristol-Myers Squibb (United States), The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, Yale Cancer Center, Yale University
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
Funders: Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Gilead Sciences, Regeneron Pharmaceuticals, Health Resources and Services Administration, Genentech, Sanofi Genzyme, Kite Pharma, Legend Biotech, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Allergy and Infectious Diseases
OpenAlex ID: W4405906879