EHA 2025 | Updates in CAR-T for myeloma: 5-year follow-up of CARTITUDE-1 & the QUINTESSENTIAL trial of arlo-cel

So what’s really exciting is we have the five-year CARTITUDE-1 data now that actually shows 33% of patients that have had an overall PFS of greater than five years and these patients are currently still going on without any relapse. This is the first time that in myeloma we have a plateau for treatment especially in relapsed/refractory patients where we’ve not seen that before. You know, we compare stem cell transplant, sometimes we say that 10 to 15% of patients get that long-term PFS. But a lot of these patients are on continued therapy like lenalidomide maintenance. Or even if they stop, these are usually frontline patients. So in CARTITUDE-1, to see patients that have had five lines of therapy with one dose of cells and not any kind of maintenance or consolidation and truly are off all therapy to actually still be in remission five years later is pretty impressive. And they show that 12 of those patients, even though they’re at one center, that they’re doing MRD testing for bone marrow every year and they’re still MRD undetectable, which is fantastic. So I’m hoping, I’m really hoping that five years from now, we’ll see that those patients are still in remission. 

But I think that, you know, for those other 66% of patients that did relapse, you know, one, we’re learning to say, who are those patients? Maybe they had a little bit more myeloma coming in. They didn’t really see a difference in high-risk features like extramedullary disease or high-risk cytogenetics, but it could be that you know high-risk is different for different patients. But again if you have less disease burden it seems to be that you do better, so again now we’re trying to go earlier so patients can get better bridging therapy to have less disease burden going into the treatment. So we’re learning a lot from this long-term data. 

But also for those patients who don’t respond or don’t last five years or eventually do relapse, I think the other big study that I’m excited that I’ll be presenting as a poster is a trial in progress for QUINTESSENTIAL, and this is arlo-cel. So this is another CAR-T, but it goes after GPRC5D, so a different target. And so far in the phase one data that we’ve had, Susan Bal has presented that before, but we’ve had over 80% response rates for patients who have had prior BCMA therapy and you know over 90 percent 95 percent response rates for people who are BCMA naive. So the QUINTESSENTIAL study is actually the pivotal study to actually get FDA approval hopefully soon for another CAR-T but again a different target. And the study actually looks at patients who are BCMA-exposed, so patients have already had BCMA therapy that can now get a GPRC5D CAR-T, and again a one and done so no other treatment. And so far, again, we’ve had great response rates and some PFS data for the Phase I, but hopefully we’ll be done with enrollment in the near future for the QUINTESSENTIAL study so that we can then present the data and also hopefully submit to the FDA for future standard of care approval. So really exciting times for novel therapies such as CAR-T cells.

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