Bridging Therapy Shows Low Efficacy in Patients With Multiple Myeloma Receiving CAR-T Therapy

Bridging therapy may not improve outcomes among patients with relapsed or refractory multiple myeloma (MM) being treated with chimeric antigen receptor (CAR)-T cell therapy, according to a real-world analysis presented at the International Myeloma Society Annual Meeting 2023.

For this study, researchers in the US Multiple Myeloma Immunotherapy Consortium evaluated whether bridging therapy affects treatment efficacy among patients with relapsed or refractory MM receiving CAR-T cell therapy.

Overall, 214 patients were enrolled to this study. Among them, 79% received a bridging therapy, which included an alkylator in 45% of patients, immunomodulatory drugs with or without monoclonal antibodies in 18%, proteasome inhibitor combinations in 15%, and selinexor in 12%. Patients in the bridging therapy group had, on average, a worse performance status and higher disease stage than did patients who did not receive bridging therapy. The median number of bridging therapy cycles was 1. The overall response rate to these therapies was 12%, with no difference between therapy subgroups.

Analysis showed that patients who received bridging therapy had worse progression-free survival (median, 6.68 months vs 11.5 months with no bridging therapy; P =.007), with a median follow-up of 9.7 months.

Overall survival was also worse in the bridging therapy group (median, 13.85 months vs no reached in the no-bridging therapy arm; P =.002). Subgroup analysis showed, however, that the overall survival finding was driven by the alkylator group (median, 11.97 months); patients in other bridging therapy subgroups had a median overall survival of not reached.

Neurotoxicity was more common, and median hospital stays longer, among patients who received bridging therapy (both P <.001).

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.

Reference

Afrough A, Hashmi H, Hansen DK, et al. Impact of bridging therapy (BT) on outcome of relapsed refractory multiple myeloma (RRMM) with ide-cel CAR T-cell therapy: real-world experience from the U.S. Myeloma CAR T Consortium. Presented at IMS 2023. September 27-30, 2023. Abstract P-002.

This article originally appeared on Hematology Advisor