Next Steps for Cilta-Cel and CARTITUDE-4 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 some of the next steps for evaluating ciltacabtagene autoleucel (cilta-cel; Carvykti) in multiple myeloma and the CARTITUDE-4 (NCT04181827) trial.

Dhakal also discusses what role he believes chimeric antigen receptor (CAR) T-cell therapy will play in the future alongside other emerging treatments for patients with myeloma and what challenges still exist.

Transcription:

0:09 | The major challenges are getting this therapy right, ensuring access to these therapies, and having referring physicians refer the patient at the right time. I think the key is offering the therapy when the patient can benefit the most with the fewest [adverse] effects, which means as early as possible. So, it is important to have that discussion with the patient, maintain communication with the referring providers, and ensure the consultation is in place so the patient can at least have a conversation and determine if they are eligible.

0:47 | One of the challenges is also the potential side effects, which, while not very common, can still occur. These risks need to be discussed with the patient so that they can weigh the risks and benefits. For diseases like myeloma, I believe this therapy will play a very important role. The data we’re seeing already shows survival benefits, even in late relapses, as well as in patients with early relapses, such as those with 1 to 3 prior lines of therapy. I think it is already establishing itself as an important treatment, especially for high-risk patients or those with poor prognostic features who would not do well with other therapies.

1:40 | This treatment is moving into the frontline setting, and we need to see how the data unfolds in terms of both safety and efficacy before offering it in that setting. I am really looking forward to that data.

1:55 | We will continue to follow these patients from CARTITUDE-4 to understand how they respond over a longer follow-up period. We are also trying to identify any other subsets or biomarkers that could predict the longevity of this response. Additionally, as I mentioned, this therapy is being investigated in the frontline setting for both transplant-eligible and -ineligible patients. I am really looking forward to those studies to see the impact of CAR T-cell therapy in the frontline setting.