Clinical and disease characteristics of the study cohort
| Demographics . | Patients who relapsed after BCMA-directed CAR-T∗ (n = 68) . |
|---|---|
| Age, median (range), y | 65 (33-77) |
| Sex, n (%) | |
| Male | 36 (53%) |
| Female | 32 (47%) |
| Disease characteristics | |
| Type of MM | IgG, 41 (61%) |
| IgA, 16 (23%) | |
| IgD, 0 (0%) | |
| IgM, 1 (2%) | |
| Light chain only, 10 (15%) | |
| Kappa, 50 (74%) | |
| Lambda, 18 (26%) | |
| Extramedullary disease present | 22 (32%) |
| Baseline plasma cell burden before CAR-T infusion, median (range) | 35% (<5 to 100) |
| Cytogenetics | (Among 52 evaluable patients) |
| 1q abnormality | 30 (58%) |
| Del17p | 14 (27%) |
| T(4;14) | 6 (12%) |
| T(14;16) | 1 (2%) |
| T(14;20) | 0 (0%) |
| T(11;14) | 12 (23%) |
| High-risk FISH | 39 (75%) |
| ≥2 high-risk FISH | 12 (23%) |
| Prior antimyeloma therapy exposure | |
| Prior LOTs | 7 (range, 1-14) |
| Prior auto-SCT transplant | 60 (88%) |
| Anti-CD38 Ab | 64 (94%) |
| Lenalidomide | 57 (98%) |
| Carfilzomib | 61 (90%) |
| Bortezomib | 63 (93%) |
| Pomalidomide | 61 (90%) |
| Cyclophosphamide or other alkylating agents | 62 (91%) |
| Venetoclax | 13 (19%) |
| Ixazomib | 13 (19%) |
| Elotuzumab | 5 (7%) |
| Selinexor | 6 (9%) |
| Panobinostat | 6 (9%) |
| Prior antimyeloma therapy refractoriness | |
| Anti-CD38 Ab | 59 (87%) |
| Lenalidomide | 45 (68%) |
| Carfilzomib | 46 (68%) |
| Bortezomib | 31 (46%) |
| Pomalidomide | 53 (78%) |
| Cyclophosphamide or other alkylating agents | 30 (44%) |
| Venetoclax | 10 (15%) |
| Ixazomib | 10 (15%) |
| Elotuzumab | 4 (6%) |
| Selinexor | 2 (3%) |
| Panobinostat | 4 (6%) |
| Triple-class refractory | 45 (66%) |
| Penta-drug refractory | 18 (26%) |
| CAR-T characteristics | |
| Commercial ide-cel | 17 (25%) |
| Commercial cilta-cel | 3 (4%) |
| Other BCMA-directed CAR-T on clinical trial | 48 (71%) |
| On trial receiving at least RP2D | 30 (44%) |
| Lymphodepletion | |
| Fludarabine/cyclophosphamide | 63 (93%) |
| Bendamustine | 4 (6%) |
| Other | 1 (1%) |
| CAR-T responses | |
| Best response: sCR | 19 (28%) |
| Best response: CR | 9 (13%) |
| Best response: VGPR | 20 (29%) |
| Best response: PR | 5 (7%) |
| Best response: SD | 10 (15%) |
| Best response: PD | 4 (6%) |
| Best response: not assessable | 1 (1%) |
| MRD negativity at any time point | 27 (40%) |
| Demographics . | Patients who relapsed after BCMA-directed CAR-T∗ (n = 68) . |
|---|---|
| Age, median (range), y | 65 (33-77) |
| Sex, n (%) | |
| Male | 36 (53%) |
| Female | 32 (47%) |
| Disease characteristics | |
| Type of MM | IgG, 41 (61%) |
| IgA, 16 (23%) | |
| IgD, 0 (0%) | |
| IgM, 1 (2%) | |
| Light chain only, 10 (15%) | |
| Kappa, 50 (74%) | |
| Lambda, 18 (26%) | |
| Extramedullary disease present | 22 (32%) |
| Baseline plasma cell burden before CAR-T infusion, median (range) | 35% (<5 to 100) |
| Cytogenetics | (Among 52 evaluable patients) |
| 1q abnormality | 30 (58%) |
| Del17p | 14 (27%) |
| T(4;14) | 6 (12%) |
| T(14;16) | 1 (2%) |
| T(14;20) | 0 (0%) |
| T(11;14) | 12 (23%) |
| High-risk FISH | 39 (75%) |
| ≥2 high-risk FISH | 12 (23%) |
| Prior antimyeloma therapy exposure | |
| Prior LOTs | 7 (range, 1-14) |
| Prior auto-SCT transplant | 60 (88%) |
| Anti-CD38 Ab | 64 (94%) |
| Lenalidomide | 57 (98%) |
| Carfilzomib | 61 (90%) |
| Bortezomib | 63 (93%) |
| Pomalidomide | 61 (90%) |
| Cyclophosphamide or other alkylating agents | 62 (91%) |
| Venetoclax | 13 (19%) |
| Ixazomib | 13 (19%) |
| Elotuzumab | 5 (7%) |
| Selinexor | 6 (9%) |
| Panobinostat | 6 (9%) |
| Prior antimyeloma therapy refractoriness | |
| Anti-CD38 Ab | 59 (87%) |
| Lenalidomide | 45 (68%) |
| Carfilzomib | 46 (68%) |
| Bortezomib | 31 (46%) |
| Pomalidomide | 53 (78%) |
| Cyclophosphamide or other alkylating agents | 30 (44%) |
| Venetoclax | 10 (15%) |
| Ixazomib | 10 (15%) |
| Elotuzumab | 4 (6%) |
| Selinexor | 2 (3%) |
| Panobinostat | 4 (6%) |
| Triple-class refractory | 45 (66%) |
| Penta-drug refractory | 18 (26%) |
| CAR-T characteristics | |
| Commercial ide-cel | 17 (25%) |
| Commercial cilta-cel | 3 (4%) |
| Other BCMA-directed CAR-T on clinical trial | 48 (71%) |
| On trial receiving at least RP2D | 30 (44%) |
| Lymphodepletion | |
| Fludarabine/cyclophosphamide | 63 (93%) |
| Bendamustine | 4 (6%) |
| Other | 1 (1%) |
| CAR-T responses | |
| Best response: sCR | 19 (28%) |
| Best response: CR | 9 (13%) |
| Best response: VGPR | 20 (29%) |
| Best response: PR | 5 (7%) |
| Best response: SD | 10 (15%) |
| Best response: PD | 4 (6%) |
| Best response: not assessable | 1 (1%) |
| MRD negativity at any time point | 27 (40%) |
Auto-SCT, autologous stem cell transplant; CR, complete response; FISH, fluorescent in situ hybridization; MRD, minimal residual disease (10−6 threshold); sCR, stringent complete response; SD, stable disease; VGPR, very good partial response.
Characteristics at the time of initial BCMA-directed CAR-T infusion.