Cilta-cel, a BCMA-targeting CAR-T therapy for patients with multiple myeloma

Sundar Jagannath, Carolyn C. Jackson, Jordan M. Schecter, Nikoletta Lendvai, Huabin Sun, Muhammad Akram, Nitin Patel, Thomas G. Martin

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Introduction: Ciltacabtagene autoleucel (cilta-cel), a BCMA-targeting CAR-T therapy, is approved in the United States and Europe for patients with relapsed/refractory multiple myeloma (RRMM) and ≥1 prior line of therapy (LOT), including a proteasome inhibitor and an immunomodulatory drug, and are lenalidomide refractory. Areas covered: We examine recent long-term data in heavily pretreated RRMM (LEGEND-2, CARTITUDE-1) and earlier LOTs (CARTITUDE-4) compared with standard therapy and discuss the rationale for investigating cilta-cel as frontline therapy for transplant-eligible and transplant-ineligible patients (CARTITUDE-5, CARTITUDE-6). Expert opinion: CAR-T therapies can improve outcomes for patients with MM across different LOTs. CARTITUDE-1 and CARTITUDE-4 have set a new bar for efficacy, with median PFS of 34.9 months in heavily pretreated patients (CARTITUDE-1) and a 74% relative risk reduction for progression/death versus standard care in patients with 1–3 prior LOTs (CARTITUDE-4), with manageable safety. Response rates were consistent between the two studies: 98% in CARTITUDE-1 and approaching 100% for infused patients in CARTITUDE-4. Cilta-cel could be a key treatment choice for patients with RRMM after first LOT. Clinical trials investigating frontline cilta-cel therapy will provide valuable insights into optimizing treatment pathways with the aim to potentially cure MM.

Original languageEnglish
Pages (from-to)339-350
Number of pages12
JournalExpert Opinion on Biological Therapy
Volume24
Issue number5
DOIs
StatePublished - 2024

Keywords

  • B-cell maturation antigen (BCMA)
  • chimeric antigen receptor (CAR)-T–cell therapy
  • ciltacabtagene autoleucel (cilta-cel)
  • lenalidomide-refractory
  • multiple myeloma
  • newly diagnosed multiple myeloma
  • progression-free survival
  • relapsed/refractory multiple myeloma

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