Leyla Shune, MD, Discusses the Clinical Significance of Ide-Cel Data From ASH 2023

Leyla Shune, MD, of the University of Kansas Hospital, met with Blood Cancers Today to discuss promising findings on idecabtagene vicleucel (ide-cel), a chimeric antigen receptor (CAR) T-cell therapy for multiple myeloma, that were presented at the 65th American Society of Hematology Annual Meeting & Exposition.

“We previously knew that in the KarMMa-3 trial patients were randomized to either CAR-T or standard of care after receiving two to three lines of myeloma therapy. And in that study, we saw that CAR-T had the better progression-free survival compared [with] the standard of care.”

Dr. Shune highlighted the promising results of ide-cel in this cohort of patients with fewer previous lines of therapy than the current US Food and Drug Administration (FDA) indication.

“I think as a myeloma community we are excited at the prospect of providing CAR-T earlier to our patients after two to three lines. With the current FDA-approved products, patients have been exposed to multiple lines of therapy; they’re older, more frail, and obviously have had T-cell exhaustion. Our hope is to offer CAR-T earlier in the myeloma journey, with the hope that there’s less attrition and loss of patients down the road.”

Dr. Shune also discussed the limitations of the current definition of prior lines of therapy when it comes to patients with multiple myeloma and eligibility for CAR T-cell therapies.

“Patients in the current era will receive [daratumumab plus lenalidomide, bortezomib, and dexamethasone] as a primary standard of care, or [daratumumab plus carfilzomib, lenalidomide, and dexamethasone], so our patients will be exposed to almost all classes of therapy…I think moving CAR-T earlier will abrogate this line of therapy business because, in reality, a person who is triple class exposed, triple class refractory, and very high risk should be offered CAR-T, and we should not be waiting for four lines.”