Hi, my name is Danae Dima. I'm an assistant professor at Fred Hutch Cancer Center in Seattle. And today I'm going to talk about the work that I've been doing with the Myeloma, multiple myeloma immunotherapy consortium about the clistium of outcomes in patients with prior BCMA-directed therapy. So just a few things about the US multiple myeloma immunotherapy consortium. Right now there are a lot of institutions all across the US that are participating and they're providing data about patients with multiple myeloma that are treated with CAR-T cell therapies and bispecific antibodies. And that's a great collaboration. I'm going to talk about the clistumab and I know that a lot of patients are concerned because they have prior BCMA-directed therapies such as an antibody tract conjugate or a lot of patients have CAR-T and they're not sure how they're going to respond to the newer bispecifics such as the clistumab and other ones that have approved after to clistumab. So I think this is an important topic to discuss and an important topic for further research. I'm going to start and go ahead and say what our study found and what it focused to. So again, it was a retrospective analysis that included 14 centers from the US, a total of 385 patients that had received to clistumab participating in that retrospective analysis. Half of these patients had prior BCMA-directed therapy. Most of those patients with prior BCMA-directed therapy, they had received just one prior BCMA-directed therapy and most of them had received CAR-T, particularly IDA cell, followed by patients who had received antibody drug conjugates and most of them had received BlendRip. And we had a total of 42 patients that had received two prior BCMA-directed regimens and most of them had the combination of antibody drug conjugate and CAR-T cell therapy. So the first thing that we did was to check responses to the clistumab and we actually found that the patients that had received the prior BCMA-directed therapy had lower response at 48% compared to patients who had not received the prior BCMA-directed therapy. Their response was 61.5%. However, that did not reach statistical significance in our analysis. We just focused only on the patients who had received prior BCMA-directed therapy and we checked the responses to the clistumab based on the type of most recent BCMA-directed agent that had received and we found that those who had received CAR-T or ADC, they had better response to the clistumab compared to those who had received prior bispecifics. However, that group was really small so we can't really make any generalizations out of that. We then focused on survival outcomes, what we call progression-free survival, and again we saw that patients with prior BCMA-directed therapy had lower PFS compared to those who did not receive a prior BCMA-directed therapy. However, again, when we put all the data in a multivariate analysis, that was not significant. And then we examined PFS based on prior type of BCMA, number of prior BCMA agents, and depth of response to prior BCMA-directed therapy and we did not find any of these being significant or impacting PFS. The last thing we did was just look at timing between sequencing of the clistumab with prior BCMA-directed therapies and our analysis showed that the optimal cut of time between that sequencing was nine months. So basically, our take home point from that study is that yes, patients with prior BCMA-directed therapies have lower responses and PFS, however, that was not statistically significant. And maybe waiting nine months between prior BCMA therapy and the clistumab initiation might be optimal for maximum progression-free survival benefit. So overall, we do support the clistumab after prior BCMA therapies. We do think that this is a viable option. However, of course, more research is needed and more biomarker development is needed to make sure that we actually select the right patients for that reason.
HealthTree • December 13, 2024