Relapsed/Refractory Multiple Myeloma: Cellular Therapies

In Multiple Myeloma Today’s roundtable series discussing research presented at ASH 2021, moderator Dr. Saad Usmani is joined by Dr. Sham Mailankody to discuss cellular therapy in Relapsed/Refractory Multiple Myeloma. In this video, Sham Mailankody highlights PFS findings in cell-to-cell therapy and his own GPRC5D study, looking at a new target for CAR T-cell therapy in myeloma.

Saad Usmani:

Last topic for our group is relapse refractory space. I think we can dedicate a whole hour on this but unfortunately, we only have a few minutes. So I’ll start with you, Sham, maybe you can start with the cellular therapies. And then, Cesar, you take the bispecifics and small molecules and then all of us chime in.

Sham Mailankody:

The most interesting cellular therapy data I thought was the long-term follow-up that Dr. Martin presented for cell-to-cell. The median PFS has not yet been reached at two years of follow up, which is really quite remarkable for this very advanced multiple myeloma population. That even after two years of follow up, we’re not seeing a median PFS for the entire cohort of patients, 90 plus patients who were treated on COG2. So that to me is certainly very, very heartening to see especially as cell-to-cell will likely be available soon for our patients.

The risk of doubting my own study, I thought the GPRC5D study we presented from MSK looking at a new target for CAR T-cell therapy in myeloma. We looked at GPRC5D for which there is already a BiTE. But this is the first CAR T cell phase one study. It’s study that included more than half of the patients with prior BCMA therapies, majority of about 50% had previous BCMA CAR T-cell therapy. So looking at a pretty advanced population, showing that you can see responses in this group, durable responses, the overall response rate was about 69%. We have patients out now nine, 10, 11 months with ongoing responses, so that’s quite reassuring to see.

There’s also data from the allogeneic CAR-T cells, which again, needs more data, more patients, longer follow-up to decide if this is going to be something we’ll be able to do more readily for our patients, but certainly providing additional cellular options in the future for patients with multiple myeloma. I think those were the major kind of… And then there was updates from bb21217, which is the next generation IDA cell if you will. I think that the duration of response was promising, although I would have liked to see more depth of response compared to IDA cell which necessarily did not… Or even maybe depth of response at lower doses, that did not really seem to happen. So, I guess, the jury’s still out whether 21217 will outperform IDA cell. Those for me were the key clinical cellular therapy abstracts, I think. Saad, you’re on mute.

Saad Usmani:

Yeah. Now I’m guilty of being mute. I think, I agree. I was hoping that the bb21217 data may actually be a bit better but it’s like it’s the same product. We might see some differences in durability, but that’s about it. I wasn’t as enthused.