Studies of BT approaches before CAR-T therapy in MM
| Study details . | Zafar et al2 . | Afrough et al3 . | Frenking et al1 . | |||
|---|---|---|---|---|---|---|
| More intensive . | Less intensive . | More intensive . | Less intensive . | More intensive . | Less intensive . | |
| Cohorts | ||||||
| Definition | hyper-CVAD | Weekly Cy | Alkylator-based | No bridging | 2+ alkylators | 1 alkylator |
| Sample size, n | 29 | 23 | 76 | 44 | 21 | 55 |
| Previous LOT | 5 (3-12) | 7 (2-13) | 6 (4-18) | 6 (4-16) | 6 (5-7) | 5 (5-6) |
| Efficacy | ||||||
| PD during BT | 52% | 39% | N/A | N/A | 38% | 56% |
| mPFS, mo | 5.0 (3.3 to NR) | 12.5 (9.4-24.5) | 6.5 (4.2-8.2) | 11.5 (NR to NR) | 5.1 (2.7 to NR) | 9.2 (7.5 to 16.9) |
| mOS, mo | 15.3 (6.0 to NR) | 30.0 (28.6 to NR) | 12.0 (8.9-15.5) | NR (NR to NR) | NR (13.0 to NR) | NR (NR to NR) |
| Safety | ||||||
| CRS | 74% | 91% | 88% | 84% | 76% | 93% |
| ICANS | 9% | 9% | 17% | 4% | 5% | 11% |
| ANC recovery | 17 days | 12.5 days | N/A | N/A | 63 days | 21 days |
| PLT recovery | 64 days | 42 days | N/A | N/A | 55 days | 42 days |
| Study details . | Zafar et al2 . | Afrough et al3 . | Frenking et al1 . | |||
|---|---|---|---|---|---|---|
| More intensive . | Less intensive . | More intensive . | Less intensive . | More intensive . | Less intensive . | |
| Cohorts | ||||||
| Definition | hyper-CVAD | Weekly Cy | Alkylator-based | No bridging | 2+ alkylators | 1 alkylator |
| Sample size, n | 29 | 23 | 76 | 44 | 21 | 55 |
| Previous LOT | 5 (3-12) | 7 (2-13) | 6 (4-18) | 6 (4-16) | 6 (5-7) | 5 (5-6) |
| Efficacy | ||||||
| PD during BT | 52% | 39% | N/A | N/A | 38% | 56% |
| mPFS, mo | 5.0 (3.3 to NR) | 12.5 (9.4-24.5) | 6.5 (4.2-8.2) | 11.5 (NR to NR) | 5.1 (2.7 to NR) | 9.2 (7.5 to 16.9) |
| mOS, mo | 15.3 (6.0 to NR) | 30.0 (28.6 to NR) | 12.0 (8.9-15.5) | NR (NR to NR) | NR (13.0 to NR) | NR (NR to NR) |
| Safety | ||||||
| CRS | 74% | 91% | 88% | 84% | 76% | 93% |
| ICANS | 9% | 9% | 17% | 4% | 5% | 11% |
| ANC recovery | 17 days | 12.5 days | N/A | N/A | 63 days | 21 days |
| PLT recovery | 64 days | 42 days | N/A | N/A | 55 days | 42 days |
Key details of each study were omitted for brevity, including the heterogeneity in patient populations, length of follow-up, exact definitions of each calculated outcome, and additional cohorts of analyzed BT regimens. For median previous LOT, parenthetical amounts summarize ranges for 2 studies2,3 and interquartile ranges for the third study (by Frenking et al). For mPFS and mOS in all 3 studies, parenthetical amounts summarize the 95% confidence intervals.
ANC, absolute neutrophil count; CRS, cytokine release syndrome; Cy, cyclophosphamide; hyper-CVAD, modified hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone (see Zafar et al2 for details); ICANS, immune effector cell–associated neurotoxicity syndrome; mOS, median overall survival; mPFS, median progression-free survival; N/A, not available; NR, not reached; PD, progressive disease; PLT, platelet.