Key takeaways:

• No significant differences occurred in PFS or OS according to race or ethnicity among CAR-T recipients with advanced multiple myeloma.
• Black and white patients experienced similar overall response rates.

Black, Hispanic and white individuals treated with idecabtagene vicleucel for relapsed or refractory multiple myeloma experienced similar PFS and OS, according to study results published in Blood Advances.

The findings should be confirmed in larger samples of diverse patients with relapsed or refractory multiple myeloma with longer follow-up time, researchers concluded.

Rationale and methodology

The clinical outcomes of standard-of-care treatment with the chimeric antigen receptor T-cell therapy among racially and ethnically diverse populations have been understudied, according to Lauren C. Peres, PhD, epidemiologist at Moffit Cancer Center.

“Non-Hispanic Black individuals are twice as likely to develop multiple myeloma compared to their white counterparts,” Peres said in an ASH-issued press release.

“We also know that Black patients are less likely to receive these novel CAR-T therapies and are less represented in clinical trials,” Peres added. “With this study, we wanted to look at how outcomes differ between racial and ethnic groups.”

Peres and colleagues examined racial and ethnic differences in incidence of toxicities and adverse events, as well as response to treatment and survival with idecabtagene vicleucel (Abecma; Bristol Myers Squibb, 2seventy bio), also known as ide-cel.

They gathered data from 207 patients (72% white; 17% Black; 11% Hispanic) with relapsed or refractory multiple myeloma treated with ide-cel across 11 institutions.

Findings

At a median follow-up of 9.3 months, results showed no significant differences in PFS or OS according to race or ethnicity.

Researchers observed similar best overall response rates between Black (86%) and white patients (86%; P = .01), with a lover ORR among Hispanic patients (59%).

Of note, Black patients experienced higher median levels of C-reactive protein (3.5 mg/dL) compared with Hispanic (1 mg/dL) and white patients (0.8 mg/dL; P = .02).

Researchers also observed higher baseline ferritin levels among Black patients (680.5 ng/mL) compared with Hispanic (362 ng/mL) and white patients (307 ng/mL).

Additionally, Black patients experienced a higher likelihood for the development of cytokine release syndrome (97%) compared with Hispanic (77%) and white patients (85%; P = .04).

Researchers acknowledged limitations of the study, including that FDA approval of ide-cel for commercial use limited its sample size and length of follow-up. In addition, researchers could not assess less common racial and ethnic groups as well as ethnic subgroups, which may mask subgroup heterogeneity in the associations of race and ethnicity with safety and clinical outcomes in the study population.

Implications

“With this study, we see that Black and white patients with multiple myeloma both respond well to ide-cel,” Peres said in the release. “We hope that these findings encourage the use of ide-cel in all patients with multiple myeloma.”

References:

CAR T-cell therapy effective in patients with blood cancer regardless of race (press release). Available at: https://www.hematology.org/newsroom/press-releases/2023/car-t-cell-therapy-effective-in-patients-with-blood-cancer-regardless-of-race. Published Oct. 19, 2023. Accessed Oct. 27, 2023.
Peres LC, et al. Blood Adv. 2023;doi:10.1182/bloodadvances.2023010894.

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