Evaluating Cilta-Cel’s Efficacy in the CARTITUDE-4 Trial

EP: 1.Overview of the CARTITUDE-4 Trial: Cilta-Cel in Multiple Myeloma

EP: 2.Key Findings From the CARTITUDE-4 Trial of Cilta-Cel in Multiple Myeloma

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EP: 3.Evaluating Cilta-Cel’s Efficacy in the CARTITUDE-4 Trial

EP: 4.Key Takeaways From the CARTITUDE-4 Trial in Multiple Myeloma

Binod Dhakal, MD, MS, assistant professor of medicine in the Division of Hematology and Oncology at the Medical College of Wisconsin, discusses how the efficacy results observed with ciltacabtagene autoleucel (cilta-cel; Carvykti) in the CARTITUDE-4 (NCT04181827) trial compare with other therapies that are used for the treatment of relapsed/refractory multiple myeloma.

Transcription:

0:09 | If you look at the available options in patients with 1 to 3 prior lines of therapy, there are many of them. For example, there are CD38-based regimens like daratumumab [Darzalex], carfilzomib [Kyprolis], dexamethasone, or isatuximab [Sarclisa], carfilzomib, [and] dexamethasone, and there are non CD38 containing regimens like selinexor, bortezomib, dexamethasone, elotuzumab, lenalidomide, dexamethasone, and and there are multiple others.

0:44 | Now, again, it is difficult to have the cross trial comparison, and also, all these triplet regimens that I mentioned before were approved based on studies that compared the triplet to doublet backbone and where the triplets showed significant benefit compared [with] doublet and that relates to the approval.

1:04 | In CARTITUDE-4, we are comparing cilta-cel with the triplet regiments, with the DPd and/or PVd. The median progression-free survival at 33 months is not reached in [the] cilta-cel [arm]. When you look at that, just looking at the pure magnitude of the PFS benefit, this looks pretty impressive when compared with the other regimens that could provide a PFS benefit in the same patient population.

1:36 | For example, some of the best regiments in that space that provide the longest PFS as daratumumab, carfilzomib, and dexamethasone, the PFS is about 26 to 30 months. Similarly, the isatuximab, carfilzomib, and dexamethasone [combination] is about 40 months. Again, this study will still need to mature to have a different PFS or have a little bit longer follow-up to see what is the different PFS, median PFS in these patients. But looking at 33.6 months, it looks pretty promising that the cilta-cel is an effective treatment as compared [with] other regiments in this space.

2:20 | What is important to see is that cilta-cel benefited all prespecified subgroups, not only the len[alidomide]-refractory patients, which is the main patient population, but also patients who have high-risk cytogenetics, extramedullary disease…including the CD38 refractory patients. There are 25% of patients with CD38-refractory and the CD38-refractory patients did derive benefit from cilta-cel as well. In summary, if you look at all these factors, I think cilta-cel seems to be one of the most effective [treatments] in this space.

REFERENCE:

Mateos M-V, San-Miguel J, Dhakal, et al. Overall survival (OS) with ciltacabtagene autoleucel (Cilta-cel) versus standard of care (SoC) in lenalidomide (Len)-refractory multiple myeloma (MM): Phase 3 CARTITUDE-4 study update. Presented at: 2024 International Myeloma Society Annual Meeting; September 25-28, 2024; Rio de Janeiro, Brazil. Abstract OA – 65.