Retrospective comparison of standard-of-care idecabtagene vicleucel and ciltacabtagene autoleucel in relapsed or refractory multiple myeloma

Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) are two BCMA-directed CAR T-cell therapies with remarkable efficacy in relapsed or refractory multiple myeloma (RRMM). A retrospective chart review of RRMM patients of 19 centers of the US Multiple Myeloma Immunotherapy Consortium compared ide-cel and cilta-cel in terms of safety and efficacy. The ide-cel group consisted of 350 treated patients and the cilta-cel group of 230 patients, with median follow-up of 12.6 months and 13.0 months, respectively. Cilta-cel was associated with higher likelihood of grade ≥ 3 cytokine release syndrome, infections, second primary malignancies, and delayed neurotoxicity, but also with better treatment responses, longer progression-free survival, and longer overall survival. No association were observed between therapy type and ICANS, any CRS, severe cytopenia at days 30 and 90, or nonrelapse mortality. The authors conclude that cita-cel demonstrated superior efficacy and survival, with a higher incidence of certain toxicities, compared with ide-cel.