Considerations When Selecting Patients With R/R Myeloma for Cilta-Cel Treatment

Jesus Berdeja, MD, director of myeloma research at Sarah Cannon Research Institute and hematology specialist at Tennessee Oncology, shares factors oncologists in the community should consider when referring patients for chimeric antigen receptor (CAR) T-cell therapy with the newly approved agent ciltacabtagene autoleucel (cilta-cel; Carvykti).

The FDA granted approval to the agent for the treatment of patients with relapsed/refractory multiple myeloma who have received 4 or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.

Access to CAR T cells has been difficult. To ensure patients get the treatment they need, he suggests early referral to CAR T-cell therapy.

Transcription:

0:07 | The advice is that this is a very active drug and should be considered for your patients. It's a drug that is not going to be given by the community oncologists necessarily unless they have the ability to give CAR T cells, meaning it’s a very specialized sort of centralized center. But most likely, they're going to be working with a CAR T specialist to provide these drugs. But it's important to identify your patients early on. And I would recommend that as soon as you have a patient that has been exposed to a proteasome inhibitor and IMID, and an anti-CD38 antibody and is progressing, do not wait until you've exhausted all lines of therapy.

0:43 | Ideally, that patient will be known to the CAR T-cell center and will be placed on a waitlist until they're eligible for treatment but that allows for good communication and hopefully maximize the chances that the patient will receive their CAR T cells.

1:01 | Right now, there’s a lot of competition for some of these spots. We don’t know what it will be like for cilta-cel because it was just approved. But we know that with ide-cel, the completion was fierce. There were wait times of up to 6 to 9 months for some of these patients. So, having another product hopefully will mitigate some of that, but we don’t know for sure yet. So, I would recommend that early referral so that at the right time, the patient will be eligible for the product.