Dr. Shah on the Potential Rationale for Selecting Ide-Cel Vs Cilta-Cel In Multiple Myeloma

Nina Shah, MD, a hematologist and oncologist, associate professor of medicine, Department of Medicine, at the University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses the potential rationale for selecting between the investigational CAR T-cell therapies idecabtagene vicleucel (ide-cel; bb2121) and ciltacabtagene autoleucel (cilta-cel) in relapsed/refractory multiple myeloma.

It is possible that the myeloma armamentarium will gain 2 CAR T-cell therapies in the near future, says Shah. However, selecting between the therapies if both receive FDA approval could be challenging, Shah adds.

Without comparing trials, subtle differences between ide-cel and cilta-cel have been observed, says Shah. Findings from the phase 2 KarMMA trial demonstrated a 73% overall response rate (ORR) with ide-cel, whereas the results of the phase 1/2 CARTITUDE-1 trial demonstrated an ORR of 96.9% with cilta-cel. Both products appear to induce deep and durable responses, but additional follow-up with cilta-cel is needed, says Shah.

Additionally, the median onset of cytokine release syndrome (CRS) was 2 days with ide-cel compared with 7 days with cilta-cel, which makes the latter more unpredictable in terms of toxicity management, Shah explains. As such, some patients may be better suited for ide-cel vs cilta-cel, but more data are needed, concludes Shah.