Alfred L. Garfall, MD, MS, on Ide-Cel and Lenalidomide Maintenance in MM Following Suboptimal ASCT Response
The director of the Autologous Hematopoietic Cell Transplantation, Cell Therapy and Transplant Program at the Hospital of the University of Pennsylvania discussed data from the phase 2 BMT CTN 1902 trial.
This video originally appeared on our sister site, OncLive®.
“We set a bar for ourselves to see if we could increase [the proportion of patients who converted to a complete response (CR)] to at least 30%, and what we found actually was that we did even better than that by a good amount. Sixty-three percent of patients converted to CR, and another 24% upgraded their response in some other way. A total of 87% of patients improved their response to some extent.”
Bristol Myers Squibb and 2seventy bio's idecabtagene vicleucel (ide-cel, marketed as Abecma), an FDA-approved chimeric antigen receptor T-cell (CAR-T) therapy, is currently being evaluated in conjunction with subsequent lenalidomide (Revlimid) maintenance in the phase 2 BMT CTN 1902 clinical trial (NCT05032820) for the treatment of patients with multiple myeloma (MM) who had a suboptimal response following upfront autologous stem cell transplant (ASCT) and maintenance lenalidomide. Data from this study were recently presented at the 2025 Tandem Meetings |Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR, held in Honolulu, Hawaii, February 12 to 15, 2025, by Alfred L. Garfall, MD, MS, the associate professor of medicine (hematology-oncology) and director of the Autologous Hematopoietic Cell Transplantation, Cell Therapy and Transplant Program at the Hospital of the University of Pennsylvania.
CGTLive®'s sister site OncLive®, spoke with Garfall to learn more. In an interview with OncLive, Garfall explained that, historically, patients who do not achieve a complete response (CR) following ASCT and lenalidomide maintenance do not typically convert to a CR down the line, and noted that for BMT CTN 1902, the investigators projected that this happens in approximately 10% of patients. As such, the primary end point for the study was set as the CR rate at 6 months following ide-cel infusion, with the goal of increasing that rate to at least 30%.
The results showed that 63% of patients (n =38) achieved a CR, and an additional 24% of patients experienced an upgraded response without reaching a CR, leading to an overall response improvement rate of 87%.
With regard to safety, cytokine release syndrome (CRS) was observed in 81.6% of patients, with all cases limited to grade 1 (68.4%) or grade 2 (13.2%). The median time to CRS onset was 1 day (range, 0-4), with resolution occurring at a median of 2.5 days (range, 0-6). Tocilizumab was administered in 77% of cases, and corticosteroids were used in 23% of patients with CRS. Notably, there were no cases of immune effector cell–associated neurotoxicity syndrome observed.
