Merz, Maximilian and Gagelmann, Nico and Smaili, Samih and Flossdorf, Sarah and Sauer, Sandra and Scheid, Christof and von Tresckow, Bastian and Wulf, Gerald and Weisel, Katja and Blau, Igor Wolfgang and Engelhardt, Monika and Wasch, Ralph and Schub, Natalie and Teipel, Raphael and Hecker, Judith and Waldschmidt, Johannes and Besemer, Britta and Baermann, Ben-Niklas and Call, Simon and Hansmann, Leo and Ayuk, Francis Ayuketang and Raab, Marc S. and Einsele, Hermann and Platzbecker, Uwe and Kroger, Nicolaus (2025) Remission conversion drives outcomes after CAR T-cell therapy for multiple myeloma: a registry analysis from the DRST. BLOOD, 146 (14). pp. 1677-1686. ISSN 0006-4971, 1528-0020
Full text not available from this repository. (Request a copy)Abstract
Cellular therapies targeting B-cell maturation antigen have shown promise in controlled clinical trials, but their impact in broader, diverse patient populations remains underexplored. This study examines the real-world efficacy and safety in 343 triple-class-exposed patients with relapsed and refractory multiple myeloma who received idecabtagene vicleucel (ide-cel; n = 266) or ciltacabtagene autoleucel (cilta-cel; n = 77) after >3 previous lines of therapy in Germany. Cilta-cel, compared with ide-cel, demonstrated superior outcomes, achieving a higher overall response rate (94% vs 82%) and 10-month progressionfree survival (PFS; 76% vs 47%). Cilta-cel also led to higher complete response (CR; 61% vs 39%) and improved response conversion, with more patients achieving CR after starting from less than CR before chimeric antigen receptor T-cell (CAR T) therapy. For those attaining CR after therapy, cilta-cel showed longer PFS, especially in patients who entered treatment with a partial response or worse. Cytokine release syndrome was observed in 85% of cilta-cel and 81% of ide-cel cases, predominantly low grade. Immune effector cell- associated neurotoxicity syndrome was more common with cilta-cel (25% vs 15%), although nonrelapse mortality at 10 months was comparable between therapies (7% vs 5%). Weighted multivariable analysis after propensity score matching confirmed a significant advantage in terms of PFS for cilta-cel, with a hazard ratio of 0.48. Overall, outcomes in our registry analysis were comparable with the pivotal trials that led to approval of the respective agents. Cilta-cel demonstrated a greater capacity for response conversion and durable remission. These findings underscore the need for individualized CAR T therapy selection to optimize patient outcomes.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Mar 2026 12:48 |
| Last Modified: | 26 Mar 2026 12:48 |
| URI: | https://pred.uni-regensburg.de/id/eprint/67983 |
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