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治疗复发性或耐火性多发性骨髓瘤的idecabtagene vicleucel或ciltacabtagene autoleucel:一项国际多中心研究

Maximilian Merz¹, Anca-Maria Albici², Bastian von Tresckow³

¹Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Diseases Universitätsklinikum Leipzig Leipzig Germany.

|January 17, 2025

概括

与idecabtagene vicleucel (ide-cel) 相比,Ciltacabtagene autoleucel (cilta-cel) 在复发性/耐药性多发性骨髓瘤中表现出更好的结果. 这项现实研究发现,使用cilta-cel.的反应率更高,无进展生存率更好.

科学领域:

血液学血液学血液学
免疫治疗是一种免疫疗法.
在瘤学瘤学.

背景情况:

伊德卡巴泰基因维克卢塞尔 (ide-cel) 和基尔塔卡巴泰基因自动基因 (cilta-cel) 是针对复发性/耐药性多发性骨髓瘤 (RRMM) 的新型CAR T细胞疗法.
在RRMM中,ide-cel和cilta-cel之间的直接比较研究是有限的.

研究的目的:

为了比较ide-cel与cilta-cel在现实世界RRMM队列中的疗效和安全性.
为了评估CAR-T细胞扩张和相关毒性的差异.

主要方法:

一个国际多中心RRMM队列的回顾性分析.
对ide-cel (n=162) 和cilta-cel (n=42) 的结果进行比较.
同一级终点:整体应答率 (ORR),无进展生存率 (PFS),细胞因子释放综合征 (CRS) 和免疫效应细胞相关的神经毒性综合征 (ICANS).

主要成果:

在第30天,Cilta-cel的ORR (93%对79%) 和完全响应率 (48%对26%) 显着更高.
10个月的PFS (82%vs. 47%) 和整体存活率 (90%vs. 77%) 受益于西尔塔细胞.
CRS和ICANS的发病率相似,但严重的CRS (3-4级) 与西尔塔细胞 (10%与4%相比) 高. CRS发生在较早的时间与ide-cel.
西尔塔-塞尔随后展现了与ICANS相关的CAR-T扩张 (14日与7日对比),与ICANS.

结论:

与三级暴露RRMM患者中的ide-cel相比,cilta-cel表现出更高的疗效,包括更高的ORR和改善的PFS.
虽然CRS和ICANS的发病率相似,但严重的CRS更频繁地发生在cilta-cel.
观察到明显的CAR-T细胞动态,与ICANS相关的细胞扩张.

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