51% of patients with relapsed / refractory multiple myeloma who have already received at least 3 previous treatments are alive at 2 years thanks to a new Car-T immunotherapy, ide-cel. Median overall survival is 24.8 months. Results described as “very important if we consider that for these heavily pretreated patients, before the advent of Car-T the median life expectancy was between 6 and 9 months”. The data comes from the update of the KarMMa phase 2 study which enrolled 128 patients treated with ide-cel. Presented at the Congress of the European Hematology Association (Eha), they were explored during a virtual press conference promoted by Celgene, Bristol Myers Squibb (Bms) group.
“KarMMa is the first phase 2 study with Car T cells designed and conducted for the therapy of relapsed / refractory multiple myeloma – explains Michele Cavo, director of the Institute of Hematology ‘LA Seragnoli’, Irccs Sant’Orsola-Malpighi, University of Bologna and full professor of Hematology in the same university – Patients enrolled had already received a median of 6 previous treatment regimens and 84% were refractory to all 3 classes of new drugs commonly in use, which include immunomodulating agents, inhibitors proteasome and anti-CD38 monoclonal antibodies. The median duration of follow-up was 24.8 months, the longest so far achieved with Car-T therapy in multiple myeloma. ”
“The overall response rate reached 73% in all treated patients – adds the specialist – with 33% achieving a complete response. The median duration of response was 10.9 months and the median survival free from disease progression was 8.6 months in the entire patient population. Results confirmed in all subgroups of study patients, especially those at high risk (extramedullary disease, high cytogenetic risk, etc.) “. The Seragnoli Institute actively participated in the KarMMa study, which showed results up to 5 times higher than those currently estimated for this patient population, who no longer respond to any available therapy and with a limited life expectancy, highlights Bms in a note. The study confirms the efficacy of ide-cel in the potential long-term control of the disease.
Every year – it is recalled in the note – in Italy 5,800 people are affected by multiple myeloma, a blood cancer that originates in the bone marrow and is characterized by repeated relapses. Therefore, patients need more therapeutic options in the different phases of the disease, with the aim of making it chronic even in the most severe cases.
A study on the combination of 3 different drugs was also presented at the Eha Congress – reports Bms -. The trial evaluates the efficacy and safety of different therapeutic combinations in specific patient groups. The first triplet analyzed consisted of iberdomide, dexamethasone (cortisone) and daratumumab (monoclonal antibody), the second of iberdomide, dexamethasone and bortezomib (proteasome inhibitor), the third of iberdomide, dexamethasone and carfilzomib (proteasome inhibitor).
“Iberdomide is a powerful cereblon modulator, a component of a protein complex that is the target of the immunomodulators lenalidomide and pomalidomide, compared to which it is much more potent – reports Cavo – In this study, heavily pretreated patients with at least 4 previous records were enrolled. Therapy regimens. The recommended phase 2 dose has been defined for the combination iberdomide, dexamethasone and daratumumab (1.6 mg). Identification of the dosage is a further step in the development process of iberdomide, making it more close to use in practice. Furthermore, the good tolerability of the 3 triplets based on iberdomide emerged. The efficacy profile is also relevant, with an overall response probability of 41% for the combination with daratumumab and almost 60% with the proteasome inhibitors “.