Journal: Blood
This study evaluates the real-world efficacy and safety of two CAR T-cell therapies, idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), in 343 triple-class-exposed patients with relapsed/refractory multiple myeloma in Germany.
Cilta-cel demonstrated superior outcomes compared to ide-cel, including:
- Higher overall response rate: 94% vs 82%
- Better 10-month progression-free survival: 76% vs 47%
- Greater rates of complete response: 61% vs 39%
- Improved response conversion and longer progression-free survival: Especially in patients with partial response or worse before treatment
Both therapies had comparable low-grade cytokine release syndrome incidence, though neurotoxicity was more frequent with cilta-cel. Nonrelapse mortality rates were similar between groups.
Multivariable analysis confirmed a significant progression-free survival benefit for cilta-cel, with a hazard ratio of 0.48.
These findings align with pivotal trial data and highlight the importance of personalized CAR T-cell therapy selection to maximize patient benefit.