Outcomes of older adults and frail patients receiving idecabtagene vicleucel: a CIBMTR study

Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy. There is limited data on outcomes of CAR T in older adults and frail patients with RRMM. In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups. An adapted version of the previously described simplified frailty index (SFI) was used to assess frailty. A total of 821 pts were followed for a median of 11.6 months (m, range, 1.1 -26.7 m). Of these patients, 251 (30.6%) were 70 years of age. Older adults had higher rates of immune-effector cell associated neurotoxicity syndrome (ICANS) of any grade (37.1% vs 24.2%, p<0.01), but there were no differences in grade 3 ICANS or cytokine release syndrome (CRS, any grade or grade3). Older adults had improved progression-free survival (PFS) which remained significant in a multivariable model. There was no significant difference in treatment related mortality (TRM). Frail patients (343/766) had a higher rate of ICANS of any grade (37% versus 21.5%, p<0.01) and clinically significant infections (49.6% vs 40.9%, p=0.02), but there were no significant differences in grade 3 ICANS, CRS, response, PFS, overall survival or TRM.In conclusion, older adults and frail patients with RRMM had comparable efficacy to younger and non-frail patients, respectively. These patients were at higher risk of developing ICANS but had no increase in other adverse events.

Authors

Institutions

Publication Details

Journal
Blood Advances
Published
2024-12-30
DOI
https://doi.org/10.1182/bloodadvances.2024014970
Citations
4
Primary Topic
CAR-T cell therapy research
Type
article
Field-Weighted Citation Impact
1.13

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Outcomes of older adults and frail patients receiving idecabtagene vicleucel: a CIBMTR study

Heather Jolie Landau, Hamza Hashmi, Aimaz Afrough, Saad Z. Usmani et al.
4 citations
Blood Advances
CAR-T cell therapy research
1.13
article

Outcomes of older adults and frail patients receiving idecabtagene vicleucel: a CIBMTR study

Heather Jolie Landau, Hamza Hashmi, Aimaz Afrough, Saad Z. Usmani, Matthew Bye, Abu‐Sayeef Mirza, Muzaffar H. Qazilbash, Surbhi Sidana, Othman Salim Akhtar, Pallavi Patwardhan, Larry D. Anderson, Doris K. Hansen, Siddhartha Ganguly, Binod Dhakal, Krina K. Patel, Jinalben Patel, Ciara L. Freeman, Taiga Nishihori, Ruta Brazauskas, Amani Kitali, Temitope Oloyede, Christopher J. Ferreri, Marcelo C. Pasquini, Nausheen Ahmed, Lohith Gowda, Devender Dhanda, Melanie J. Harrison
article en
4 citations

Abstract

Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy. There is limited data on outcomes of CAR T in older adults and frail patients with RRMM. In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups. An adapted version of the previously described simplified frailty index (SFI) was used to assess frailty. A total of 821 pts were followed for a median of 11.6 months (m, range, 1.1 -26.7 m). Of these patients, 251 (30.6%) were 70 years of age. Older adults had higher rates of immune-effector cell associated neurotoxicity syndrome (ICANS) of any grade (37.1% vs 24.2%, p<0.01), but there were no differences in grade 3 ICANS or cytokine release syndrome (CRS, any grade or grade3). Older adults had improved progression-free survival (PFS) which remained significant in a multivariable model. There was no significant difference in treatment related mortality (TRM). Frail patients (343/766) had a higher rate of ICANS of any grade (37% versus 21.5%, p<0.01) and clinically significant infections (49.6% vs 40.9%, p=0.02), but there were no significant differences in grade 3 ICANS, CRS, response, PFS, overall survival or TRM.In conclusion, older adults and frail patients with RRMM had comparable efficacy to younger and non-frail patients, respectively. These patients were at higher risk of developing ICANS but had no increase in other adverse events.

Blood AdvancesVol. 9(7)
Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), Palo Alto University (US), Baylor College of Medicine (US), Medical College of Wisconsin (US), Yale Cancer Center (US), Moffitt Cancer Center (US), Yale University (US), Bristol-Myers Squibb (United States) (US), The University of Kansas Cancer Center (US), Levine Cancer Institute (US), Versiti Blood Center of Wisconsin (US), University of Kansas Medical Center (US), Bristol-Myers Squibb (Belgium) (BE), International Society for Heart and Lung Transplantation (US), The University of Texas Southwestern Medical Center (US), Stanford University (US)
Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Gilead Sciences, Regeneron Pharmaceuticals, Health Resources and Services Administration, Genentech, Sanofi Genzyme, Kite Pharma, Legend Biotech, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Good health and well-being
Openalex Percentile: Top 17%
CAR-T cell therapy research
1.13
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.