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Clinical outcome of patients with relapsed refractory multiple myeloma listed for BCMA directed commercial CAR-T therapy

Bone Marrow Transplantation volume 58, pages 443–445 (2023)Cite this article

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The first chimeric antigen receptor T cell (CAR-T) therapy in multiple myeloma (MM), idecabtagene vicleucel, directed against B-cell maturation antigen (BCMA), was approved in March 2021 for use in relapsed/refractory (RR) disease. In clinical trials, high response rates were reported with CAR- T therapy in heavily pretreated patients with MM [1,2,3]. In limited real-world experience since approval, the use of CAR-T therapy in patients with RRMM has also resulted in high response rates; however, the outcome of patients who were eligible for CAR-T therapy but did not receive it has not been studied [4]. We investigated the real-world experience of outcomes of patients with RRMM placed on commercial CAR-T therapy wait-list since its initial approval in March 2021. Methods including patients and disease variables along with statistical analysis were provided in supplementary.

A total of 81 patients were listed for commercial CAR-T therapy between March 2021 and March 2022. Baseline characteristics are summarized in Table 1. The median time from diagnosis to waitlisting for CAR-T therapy was 4.5 (range 0.8–17.5) years. Approximately 26% (n = 21) of the patients were wait-listed for CAR-T therapy with ≤4 lines of previous therapy at the treating physician’s discretion. About 90% (n = 73) of the patients met the definition of progressive disease by the International Myeloma Working Group (IMWG) criteria [5] at the time of CAR-T therapy wait-listing. Seventy-eight (96.3%) patients were on various MM therapy at the time of progression.

Table 1 Baseline characteristics of patients.
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References

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Authors and Affiliations

  1. Myeloma Center, Division of Hematology Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Samer Al Hadidi, Munawwar Hussain, Yetunde Ogunsesan, Nishanth Thalambedu, Fatima Khan, Jaskirat Sethi, Sharmilan Thanendrarajan, Carolina Schinke, Maurizio Zangari & Frits van Rhee

  2. Bone Marrow Transplant Service, Division of Hematology Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    Aniko Szabo, Jean Esselmann, Lindsay Hammons, Abhishek Janardan, Sabarinath Venniyil Radhakrishnan, Binod Dhakal, Siegfried Janz, Anita D’Souza & Meera Mohan

  3. Division of Hematology/Oncology, Department of Medicine, Mayo Clinic, Rochester, AZ, USA

    Saurabh Chhabra

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  1. Samer Al Hadidi
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Contributions

SAH and MM conceived the research idea and wrote the initial manuscript draft. AS performed statistical analysis. All authors collected data, critically reviewed the manuscript, and approved the final version of submission.

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Correspondence to Samer Al Hadidi or Meera Mohan.

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Al Hadidi, S., Szabo, A., Esselmann, J. et al. Clinical outcome of patients with relapsed refractory multiple myeloma listed for BCMA directed commercial CAR-T therapy. Bone Marrow Transplant 58, 443–445 (2023). https://doi.org/10.1038/s41409-022-01905-1

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