髓外多发性骨髓瘤对 idecabtagene vicleucel 治疗效果的影响

IF 29.5 1区医学 Q1 HEMATOLOGY

Journal of Hematology & Oncology Pub Date : 2024-06-06 DOI:10.1186/s13045-024-01555-4

Saurabh Zanwar, Surbhi Sidana, Leyla Shune, Omar Castaneda Puglianini, Oren Pasvolsky, Rebecca Gonzalez, Danai Dima, Aimaz Afrough, Gurbakhash Kaur, James A. Davis, Megan Herr, Hamza Hashmi, Peter Forsberg, Douglas Sborov, Larry D. Anderson Jr, Joseph P. McGuirk, Charlotte Wagner, Alex Lieberman-Cribbin, Adriana Rossi, Ciara L. Freeman, Frederick L. Locke, Shambavi Richard, Jack Khouri, Yi Lin, Krina K. Patel, Shaji K. Kumar, Doris K. Hansen

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引用次数: 0

摘要

Idecabtagene vicleucel（Ide-cel）在复发性/难治性多发性骨髓瘤（RRMM）患者中表现出卓越的疗效和持久的应答。然而，髓外疾病（EMD）患者使用ide-cel的疗效仍不完全。我们纳入了2021年5月至2023年4月期间接受ide-cel治疗的11家美国学术机构的RRMM患者。与骨骼不毗连的内脏或软组织病变被归类为EMD。从输注ide-cel之日起进行时间到事件分析。在351名患者中，84人（24%）在输注前患有EMD。输注ide-cel后的中位随访时间为18.2个月（95% CI：17-19.3）。EMD组和非EMD组的第90天总体反应率（ORR）分别为52%和82%（P < 0.001）。EMD队列的中位无进展生存期（PFS）为5.3个月（95% CI：4.1-6.9），而非EMD队列为11.1个月（95% CI：9.2-12.6；P < 0.0001）。在一项多变量分析中，EMD是PFS较差的独立预测因素[危险比1.5 (1.1-2.2)，p = 0.02]。EMD队列和非EMD队列的中位总生存期分别为14.8个月[95% CI：9-未达到（NR）]和26.9个月（26.3 vs. NR，p = 0.006）。在接受ide-cel治疗的患者中，髓外疾病是90天ORR和PFS较差的独立预测因素。

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Impact of extramedullary multiple myeloma on outcomes with idecabtagene vicleucel

Idecabtagene vicleucel (Ide-cel) has demonstrated excellent efficacy and durable responses in patients with relapsed/refractory multiple myeloma (RRMM). However, the outcomes with ide-cel in patients with extramedullary disease (EMD) remain incompletely characterized. We included patients with RRMM treated with ide-cel between May 2021 and April 2023 across 11 US academic institutions. Visceral or soft tissue lesions non-contiguous from bone was classified as EMD. Time-to-event analyses were performed from date of ide-cel infusion. Among 351 patients, 84 (24%) had EMD prior to infusion. The median follow-up from ide-cel infusion was 18.2 months (95% CI: 17-19.3). The day 90 overall response rates (ORR) were 52% vs. 82% for the EMD and non-EMD cohorts, respectively (p < 0.001). The median progression-free survival (PFS) was 5.3 months (95% CI: 4.1–6.9) for the EMD cohort vs. 11.1 months (95% CI: 9.2–12.6; p < 0.0001) for the non-EMD cohort. In a multivariable analysis, EMD was an independent predictor of inferior PFS [hazard ratio 1.5 (1.1–2.2), p = 0.02]. The median overall survival was 14.8 months [95% CI: 9-Not reached (NR)] vs. 26.9 months (26.3 vs. NR, p = 0.006) for the EMD and non-EMD cohorts, respectively. Extramedullary disease represents an independent predictor of inferior day 90 ORR and PFS among patients treated with ide-cel.

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来源期刊

Journal of Hematology & Oncology 医学-血液学

CiteScore

48.10

自引率

2.10%

发文量

169

审稿时长

6-12 weeks

期刊介绍： The Journal of Hematology & Oncology, an open-access journal, publishes high-quality research covering all aspects of hematology and oncology, including reviews and research highlights on "hot topics" by leading experts. Given the close relationship and rapid evolution of hematology and oncology, the journal aims to meet the demand for a dedicated platform for publishing discoveries from both fields. It serves as an international platform for sharing laboratory and clinical findings among laboratory scientists, physician scientists, hematologists, and oncologists in an open-access format. With a rapid turnaround time from submission to publication, the journal facilitates real-time sharing of knowledge and new successes.