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SOHO 2026 | CARTITUDE-4 cytogenetic subgroup analysis: bridging therapy and cilta-cel outcomes in RRMM

Roberto Mina, MD, Winship Cancer Institute of Emory University, Atlanta, GA, discusses a subgroup analysis of the Phase III CARTITUDE-4 trial (NCT04181827) evaluating ciltacabtagene autoleucel (cilta-cel) in patients with relapse/refractory multiple myeloma (RRMM) stratified by cytogenetic risk and response to bridging therapy. Dr Mina explains that patients with standard- and high-risk disease who achieved at least a partial response to bridging therapy experienced improved outcomes with cilta-cel, highlighting the importance of effective bridging therapy. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.

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Transcript

So we presented this analysis that was based on patients that were enrolled and treated with cilta-cel in the CARTITUDE-4 study. We evaluated patients stratified according to the cytogenetic risk. So we use standard FISH to define a patient with high-risk disease, as well as a patient with standard-risk disease. Patients with high-risk disease are those who presented at least one high-risk chromosomal abnormality...

So we presented this analysis that was based on patients that were enrolled and treated with cilta-cel in the CARTITUDE-4 study. We evaluated patients stratified according to the cytogenetic risk. So we use standard FISH to define a patient with high-risk disease, as well as a patient with standard-risk disease. Patients with high-risk disease are those who presented at least one high-risk chromosomal abnormality. But we also stratified patients based on the response to bridging therapy. As we know now that responding to bridging therapy carries a potential advantage in terms of progression-free survival, a better efficacy to CAR T-cell therapy, and potentially also a better safety profile. So patients who receive CAR-T, including cilta-cel, with a lower tumor burden seem not only to have better responses, but also a better efficacy. So we stratified patients both according to the disease biology and the response to treatment. And what we saw was that in terms of progression-free survival, and also in terms of overall survival, we observed a benefit for cilta-cel in patients who had at least a partial remission to the bridging therapy as compared to patients who did not respond to bridging therapy. And this was true for patients who were at standard risk and patients also with high-risk disease. Patients with standard risk disease and who also responded to bridging therapy had at least a partial remission, had at 13 months an 85% probability of being alive and free from progression. And then this translated also into a numerically longer overall survival for a responding patient. In terms of safety, the numbers are small, so this is not a formal analysis, but we observed a potentially better safety profile for a responding patient. There were no Parkinsonisim cases for patients who had responded previously to bridging therapy. So all this data together point towards the importance of a good bridging therapy for patients who are to receive cilta-cel. And now that we are using cilta-cel in earlier lines, where there are more options for bridging therapy, including bispecific antibodies, for example, including, for example, talquetamab, I think that this is quite important to remind all our colleagues that for patients who are going to receive a CAR T-cell therapy, CAR-T product, we should really make every effort to bridge the patient and to get patients to receive CAR-T in the best response we can.

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