治疗复发/难治性多发性骨髓瘤的标准治疗方案——西他他烯维鲁和西他他烯自鲁的比较。

IF 42.1 1区 医学 Q1 ONCOLOGY
Journal of Clinical Oncology Pub Date : 2025-05-01 Epub Date: 2025-02-18 DOI:10.1200/JCO-24-01730
Doris K Hansen, Lauren C Peres, Danai Dima, Alicia Richards, Leyla Shune, Aimaz Afrough, Shonali Midha, Binod Dhakal, Mehmet H Kocoglu, Shebli Atrash, Christopher Ferreri, Omar Castaneda, James A Davis, Evguenia Bhurtel, Joseph McGuirk, Charlotte Wagner, Radhika Bansal, Patrick Costello, Kinaya Smith, Alex Lieberman-Cribbin, Gabriel De Avila, Sneha Purvey, Hitomi Hosoya, Lekha Mikkilineni, Laura B Oswald, Gurbakhash Kaur, Oren Pasvolsky, Mahmoud Gaballa, Megan M Herr, Peter Forsberg, Murali Janakiram, Myo Htut, Sireesha Asoori Maringanti, Nilesh Kalariya, Hamza Hashmi, Ran Reshef, Douglas W Sborov, Omar Nadeem, Faiz Anwer, Jack Khouri, Shahzad Raza, Djordje Atanackovic, Melissa Alsina, Ciara L Freeman, Frederick L Locke, Peter Voorhees, Larry D Anderson, Shambavi Richard, Thomas Martin, Yi Lin, Krina K Patel, Surbhi Sidana
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引用次数: 0

摘要

目的:两种b细胞成熟抗原导向嵌合抗原受体(CAR) t细胞疗法在治疗复发/难治性多发性骨髓瘤(RRMM)中表现出显著的疗效。我们比较了标准护理(SOC) ide- cell或cilta- cell治疗的RRMM患者的安全性、有效性和生存率。方法:数据来自一项回顾性图表回顾,该图表回顾了截至2022年12月31日在19家机构接受SOC ide-cel或cilta-cel治疗的RRMM白血病患者。采用治疗加权逆概率(IPTW)方法比较不同治疗类型的结果。结果:截至2022年12月31日,共有641例患者出现白血病,其中ide-cel (n = 386)和cilta-cel (n = 255)。586例患者输注(n = 350) ide-cel;N = 236 (cilta-cel), ide-cel和cilta-cel的中位随访时间分别为12.6和13.0个月。IPTW后,患者的特征得到了很好的平衡。cilta - cell与≥3级细胞因子释放综合征(CRS;优势比[OR], 6.80 [95% CI, 2.28 ~ 20.33])、感染(OR, 2.03 [95% CI, 1.41 ~ 2.92])、第二原发恶性肿瘤(OR, 1.77 [95% CI, 0.89 ~ 3.56])和迟发性神经毒性(OR, 20.07 [95% CI, 4.46 ~ 90.20])。Cilta-cel还与更好的治疗反应(≥完全缓解:OR, 2.42 [95% CI, 1.63至3.60])、更长的无进展生存期(风险比[HR], 0.48 [95% CI, 0.36至0.63])和更长的总生存期(HR, 0.67 [95% CI, 0.46至0.97])相关。未观察到治疗类型与免疫效应细胞相关神经毒性综合征、任何CRS、30天和90天严重细胞减少症或非复发死亡率之间的关联。在重复分析时,我们观察到一致的结果,将ide-cel队列限制在与美国食品和药物管理局批准cilta-cel(≥2022年3月)同一时间段内输注的患者。结论:与ide-cel相比,Cilta-cel具有更高的疗效和生存期,但某些毒性的发生率更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Standard-of-Care Idecabtagene Vicleucel and Ciltacabtagene Autoleucel in Relapsed/Refractory Multiple Myeloma.

Purpose: Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), two B-cell maturation antigen-directed chimeric antigen receptor (CAR) T-cell therapies have demonstrated remarkable efficacy in relapsed/refractory multiple myeloma (RRMM). We compare safety, efficacy, and survival among patients with RRMM treated with standard-of-care (SOC) ide-cel or cilta-cel.

Methods: Data were from a retrospective chart review of patients with RRMM leukapheresed by December 31, 2022, with the intent to receive SOC ide-cel or cilta-cel at 19 institutions. An inverse probability of treatment weighting (IPTW) approach was used to compare outcomes by therapy type.

Results: A total of 641 patients were leukapheresed by December 31, 2022, with ide-cel (n = 386) and cilta-cel (n = 255). Five hundred eighty-six patients were infused (n = 350 for ide-cel; n = 236 for cilta-cel) with a median follow-up of 12.6 and 13.0 months for ide-cel and cilta-cel, respectively. After IPTW, patient characteristics were well balanced. Cilta-cel was associated with higher likelihood of grade ≥3 cytokine release syndrome (CRS; odds ratio [OR], 6.80 [95% CI, 2.28 to 20.33]), infections (OR, 2.03 [95% CI, 1.41 to 2.92]), second primary malignancies (OR, 1.77 [95% CI, 0.89 to 3.56]), and delayed neurotoxicity (OR, 20.07 [95% CI, 4.46 to 90.20]). Cilta-cel was also associated with better treatment responses (≥complete response: OR, 2.42 [95% CI, 1.63 to 3.60]), longer progression-free survival (hazard ratio [HR], 0.48 [95% CI, 0.36 to 0.63]), and longer overall survival (HR, 0.67 [95% CI, 0.46 to 0.97]). No associations were observed between therapy type and immune effector cell-associated neurotoxicity syndrome, any CRS, severe cytopenia at days 30 and 90, or nonrelapse mortality. We observed consistent findings when repeating the analyses restricting the ide-cel cohort to patients infused during the same time period as Food and Drug Administration approval for cilta-cel (≥March 2022).

Conclusion: Cilta-cel demonstrated superior efficacy and survival, with higher incidence of certain toxicities, compared with ide-cel.

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来源期刊
Journal of Clinical Oncology
Journal of Clinical Oncology 医学-肿瘤学
CiteScore
41.20
自引率
2.20%
发文量
8215
审稿时长
2 months
期刊介绍: The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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