Details

Autor(en) / Beteiligte

• Gagelmann, Nico
• Dima, Danai
• Merz, Maximilian
• Hashmi, Hamza
• Ahmed, Nausheen
• Tovar, Natalia
• Oliver-Caldés, Aina
• Stölzel, Friedrich
• Rathje, Kristin
• Fischer, Luise
• Born, Patrick
• Schäfer, Lisa
• Albici, Anca-Maria
• Schub, Natalie
• Kfir-Erenfeld, Shlomit
• Assayag, Miri
• Asherie, Nathalie
• Wulf, Gerald Georg
• Kharboutli, Soraya
• Müller, Fabian
• Shune, Leyla
• Davis, James A
• Anwer, Faiz
• Vucinic, Vladan
• Platzbecker, Uwe
• Ayuk, Francis
• Kröger, Nicolaus
• Khouri, Jack
• Gurnari, Carmelo
• McGuirk, Joseph
• Stepensky, Polina
• Abdallah, Al-Ola
• Fernández de Larrea, Carlos

Titel

Development and Validation of a Prediction Model of Outcome After B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy in Relapsed/Refractory Multiple Myeloma

Ist Teil von

• Journal of clinical oncology, 2024-05, Vol.42 (14), p.1665-1675

Ort / Verlag

United States

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Although chimeric antigen receptor T therapy (CAR-T) cells are an established therapy for relapsed/refractory multiple myeloma (RRMM), there are no established models predicting outcome to identify patients who may benefit the most from CAR-T. This is an international retrospective observational study including patients with RRMM infused with currently available commercial or academically produced anti-B-cell maturation antigen (BCMA) CAR-T. We describe characteristics and outcomes in Europe (n = 136) and the United States (n = 133). Independent predictors of relapse/progression built a simple prediction model (Myeloma CAR-T Relapse [MyCARe] model) in the training cohort (Europe), which was externally validated (US cohort) and tested within patient- and treatment-specific subgroups. The overall response rate was 87% and comparable between both cohorts, and complete responses were seen in 48% (Europe) and 49% (the United States). The median time to relapse was 5 months, and early relapse <5 months from infusion showed poor survival across cohorts, with the 12-month overall survival of 30% (Europe) and 14% (the United States). The presence of extramedullary disease or plasma cell leukemia, lenalidomide-refractoriness, high-risk cytogenetics, and increased ferritin at the time of lymphodepletion were independent predictors of early relapse or progression. Each factor received one point, forming the three-tiered MyCARe model: scores 0-1 (low risk), scores 2-3 (intermediate risk), and a score of 4 (high risk). The MyCARe model was significantly associated with distinct 5-month incidence of relapse/progression ( < .001): 7% for low-risk, 27% for intermediate-risk, and 53% for high-risk groups. The model was validated in the US cohort and maintained prognostic utility for response, survival, and outcomes across subgroups. Outcomes of patients with RRMM after CAR-T are comparable between Europe and the United States. The MyCARe model may facilitate optimal timing of CAR-T cells in patient-specific subgroups.