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The first randomised CAR-T trial in myeloma tripled median progression-free survival (13.3 versus 4.4 months) compared with standard combinations after two to four prior lines.
KarMMa-3 randomised 386 patients with relapsed and refractory multiple myeloma after two to four prior lines, including an immunomodulatory drug, a proteasome inhibitor and daratumumab, to idecabtagene vicleucel (ide-cel) or one of five standard regimens. The primary endpoint was PFS. Median PFS was 13.3 versus 4.4 months (hazard ratio 0.49); overall response was 71% versus 42% and complete response 39% versus 5%. CRS occurred in 88% (grade 3 or higher in 5%) and neurotoxicity in 15%. Overall survival did not differ significantly, in part because more than half of standard-arm patients crossed over to ide-cel.
KarMMa-3 was the first randomised evidence that CAR-T beats conventional drugs in myeloma and led to ide-cel's approval after two prior lines. It confirmed that earlier use of CAR-T produces deeper and longer remissions than in the end-stage setting. Because responses are shorter than with cilta-cel and OS was not improved, it also sharpened debate about which BCMA CAR-T to use and when.
Shares CARTITUDE-4: cilta-cel CAR-T versus standard combinations after one to three prior lines of myeloma therapy, BCMA, Objective response rate (ORR), Cytokine release syndrome (CRS).
Shares Idecabtagene vicleucel, Bristol Myers Squibb, CAR-T cell therapy, Multiple myeloma.
Shares BCMA, Relapsed or refractory multiple myeloma, Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.
Shares BCMA, Relapsed or refractory multiple myeloma, Multiple myeloma.
Shares BCMA, Objective response rate (ORR), Cytokine release syndrome (CRS), Relapsed or refractory multiple myeloma.
Shares KarMMa-3, BCMA, Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.
Shares Objective response rate (ORR), Cytokine release syndrome (CRS), Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.
Shares CARTITUDE-4: cilta-cel CAR-T versus standard combinations after one to three prior lines of myeloma therapy, Relapsed or refractory multiple myeloma, Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.