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How Effective is Ide-cel (Abecma)?
How does ide-cel work?
With ide-cel, your T-cells have been enhanced to target BCMA on myeloma cells. Learn more at: How CAR T-cell Therapy Works.
Who can receive ide-cel?
Adult patients with relapsed or refractory myeloma are eligible for ide-cel after two or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.
To learn about more factors that may influence whether CAR-T is right for you, visit: When to Consider CAR T-cell Therapy?
When will the ide-cel infusion be ready?
The CAR-T process takes time. Since collecting your T-cells, it takes about 4 weeks for the ide-cel infusion to be ready.
During this waiting period, your doctor may recommend a temporary treatment called bridging therapy to control myeloma. This may include one or more cycles of a combination like DPd (daratumumab, pomalidomide, dexamethasone) or PVd (pomalidomide, bortezomib, dexamethasone) to help keep myeloma under control until your CAR-T infusion.
How is ide-cel administered?
Before your ide-cel infusion, you will receive a short course of chemotherapy with cyclophosphamide and fludarabine through an IV daily for three days. This step is called lymphodepletion, and it helps prepare your body so CAR-T works more effectively. Your ide-cel infusion is usually given two days after this chemotherapy. It may be delayed up to seven days if time is needed to recover from possible serious side effects of lymphodepletion, active infections, or inflammatory disorders.
About 30 to 60 minutes before the CAR-T infusion, you will be given acetaminophen and diphenhydramine by your healthcare team to help lower the risk of side effects. The ide-cel infusion itself takes between 30 and 60 minutes.
Afterward, you will be monitored closely for at least seven days for possible side effects such as cytokine release syndrome (CRS) and neurological changes. You will also need to stay near the treatment center and avoid driving for at least two weeks after the infusion. The requirements used to be longer but were recently updated based on the FDA’s removal of the Risk Evaluation and Mitigation Strategies (REMS).
How effective is ide-cel for myeloma?
Results from the KarMMa-3 trial, which led to ide-cel’s FDA approval for people with relapsed/refractory myeloma who had received two or more prior lines of therapy, showed:
- Ide-cel reduced the risk of disease progression or death by 51% percent compared to standard therapies.
- 71% of patients who received ide-cel experienced an overall response, with 39% being a complete or stringent complete response.
- The median duration of response was 14.8 months for patients who experienced an overall response, and 20 months if patients had a complete response or better.
Side effect profile of ide-cel
The chart below shows the percentage of people with myeloma who experienced side effects from ide-cel in the KarMMa-3 trial. This information can help you understand what to expect and prepare for, as well as guide conversations with your care team about managing potential side effects.
| Side effect name | Percentage of patients who experienced any version of the side effect (mild to severe/grades 1-5) | Percentage of patients who experienced a severe version of the side effect that required hospital care (grades 3-4) |
| Pyrexia (fever) | 91% | 9% |
| Cytokine release syndrome | 91% | 4.1% |
| Any infection | 56% | 16% |
| Febrile neutropenia (fever from low neutrophils) | 51% | 51% |
| Hypogammaglobulinemia (low levels of antibodies) | 48% | 0.9% |
| Musculoskeletal (muscle/bone) pain | 36% | 1.8% |
| Hypotension (low blood pressure) | 36% | 2.3% |
| Fatigue | 33% | 1.4% |
| Tachycardia (fast heartbeat) | 32% | 0% |
| Diarrhea | 31% | 2.3% |
| Nausea | 27% | 0.9% |
| Headache | 24% | 0% |
| Encephalopathy (a group of conditions that cause brain dysfunction) | 22% | 3.6% |
| Dyspnea (shortness of breath) | 21% | 1.8% |
| Edema (swelling in limbs from trapped fluid) | 20% | 0.5% |
| Chills | 19% | 0.5% |
| Hypoxia (low levels of oxygen in body tissues) | 18% | 6% |
| Decreased appetite | 17% | 1.8% |
| Constipation | 17% | 0% |
| Coagulopathy (abnormal blood clotting) | 14% | 2.7% |
| Vomiting | 14% | 0% |
| Dizziness | 14% | 1.8% |
| Cough | 14% | 0% |
| Hypertension (high blood pressure) | 14% | 7% |
| Pneumonia | 13% | 8% |
| Renal failure (conditions include chronic kidney disease, kidney failure, or kidney impairment, among others) | 13% | 5% |
| Sleep disorder | 11% | 0% |
| Abdominal pain | 10% | 0.5% |
| Neuropathy | 10% | 0% |
| Rash | 10% | 0% |
Additionally, the majority of patients experienced decreased blood counts that required supportive hospital care.
For more information on these side effects, visit: Side Effect Management of CAR T-cell Therapy for Multiple Myeloma.
For more information on ide-cel, check out the source below.
Financial resources for ide-cel
To locate financial resources for ide-cel, visit: Financial Resources for Myeloma CAR-T.