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Updated: Aug 14, 2025

An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
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Survival in Patients with Relapsed-Refractory Multiple Myeloma: Indirect Comparison of Six New Treatments

Luca Cancanelli1, Melania Rivano2, Lorenzo Di Spazio3

  • 1Hospital Pharmacy Department, Azienda Ulss 2 Marca Trevigiana, Castelfranco Veneto, 31033 Treviso, Italy.

Hematology Reports
|January 17, 2023
PubMed

Insights

This systematic review compared six treatments for relapsed-refractory multiple myeloma (RRMM). Ciltacabtagene autoleucel demonstrated superior overall survival compared to idecabtagene vicleucel, with specific non-CAR-T agents also ranked for efficacy.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • Relapsed-refractory multiple myeloma (RRMM) presents treatment challenges with emerging therapies.
  • Direct comparative data for novel RRMM treatments are limited.
  • Indirect treatment comparisons are valuable for assessing relative efficacy.

Purpose of the Study:

  • To conduct a systematic review and indirect comparison of six treatments for RRMM.
  • To evaluate and rank treatments based on overall survival (OS).
  • To assess the performance of the Shiny method for reconstructing individual patient data from Kaplan-Meier graphs.

Main Methods:

  • Systematic review of six RRMM treatments: two CAR-T (ciltacabtagene autoleucel, idecabtagene vicleucel) and four non-CAR-T (melflufen/dexamethasone, isatuximab/dexamethasone, selinexor, belantamab).
  • Reconstruction of individual patient data from Kaplan-Meier graphs using the Shiny method for indirect comparisons.
  • Primary endpoint: overall survival (OS).

Main Results:

  • Statistically significant differences in OS were observed across the evaluated treatments.
  • Ciltacabtagene autoleucel showed a statistically significant improvement in OS compared to idecabtagene vicleucel.
  • For non-CAR-T treatments, the OS ranking was: isatuximab plus dexamethasone, belantamab, selinexor, and melflufen plus dexamethasone.

Conclusions:

  • The Shiny method proved effective for reconstructing individual patient data for indirect comparisons.
  • This indirect comparison provides insights into the relative overall survival of different RRMM treatments.
  • Isatuximab plus dexamethasone emerged as a leading non-CAR-T option in terms of overall survival.
Keywords:
CAR-Tnon-CAR-T agentsoverall survivalrelapsed-refractory multiple myeloma

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