Source: Myeloma – Hematology Advisor

Lower response rates and higher incidence of cytokine release syndrome (CRS) was observed among Hispanic and Black patients with relapsed/refractory multiple myeloma (RRMM) who received chimeric antigen receptor (CAR) T-cell therapy, according to a retrospective study. However, survival rates were similar across races/ethnicities. The results of the study were published in the journal Blood Advances.

The multicenter study analyzed data from 207 patients with RRMM who received idecabtagene vicleucel (ide-cel) as part of the standard of care. Of these patients, 11% were Hispanic, 17% were non-Hispanic Black, and 72% were non-Hispanic White. 

The median age of the cohort ranged from 57 to 65 and 42% to 73% of patients were male. Extramedullary disease was present among 42% to 59% of patients and 21% to 38% had high-risk cytogenetics. The median number of prior lines of therapy ranged from 6 to 7, and 73% to 85% of patients were triple refractory and 37% to 45% were pentarefractory. There were 23% to 28% of patients who had received prior anti-BCMA treatment and 81% to 91% had a prior stem cell transplant.

Best overall response rates (ORR) were significantly lower among Hispanic patients at 59% compared with 86% among both Black and White patients (P =.01). The 90-day ORR rate was 48% among Hispanic patients compared with 66% among Black patients and 76% among White patients (P =.02). The 30-day ORR was also numerically lower among Hispanic patients, but did not reach significance.

Despite differences in safety and response to ide-cel, our findings encourage the use of ide-cel in all patients with RRMM.

There was no significant difference in progression-free survival (PFS), with a median of 4.2 months among Hispanic patients, 6.5 months among Black patients, and 8.5 months among White patients (P =.49). Overall survival was also similar, with a median not reached across all groups (P =.99).

CRS of any grade occurred most frequently among Black patients at 97% compared with 77% among Hispanic patients and 85% among White patients (P =.04). Grade 3 or higher CRS was uncommon, occurring among 3%, 0%, and 3% of Black, Hispanic, and White patients, respectively. There was no significant difference in the rates of other adverse events, including ICANS or hematologic toxicities.

The length of hospital stay was significantly longer for Black patients, with a median of 13.5 days compared with 8.0 days for Hispanic patients and 9.0 days for White patients (P =.006). However, the rates of intensive care unit admission were similar at 6%, 5%, and 11%, respectively (P =.6).

“Despite differences in safety and response to ide-cel, our findings encourage the use of ide-cel in all patients with RRMM,” the authors concluded in their report.

Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.

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