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Idecabtagene vicleucel chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma with renal impairment. Haematologica Sidana, S., Peres, L. C., Hashmi, H., Hosoya, H., Ferreri, C., Khouri, J., Dima, D., Atrash, S., Voorhees, P., Simmons, G., Sborov, D. W., Kalariya, N., Hovanky, V., Bharadwaj, S., Miklos, D., Wagner, C., Kocoglu, M. H., Kaur, G., Davis, J. A., Midha, S., Janakiram, M., Freeman, C., Alsina, M., Locke, F., Gonzalez, R., Lin, Y., McGuirk, J., Afrough, A., Shune, L., Patel, K. K., Hansen, D. K. 2023

Abstract

We evaluated patients with relapsed multiple myeloma with renal impairment (RI treated with standard of care ide-cel, as outcomes with CAR-T therapy are unknown in this population. RI was defined as creatinine clearance (CrCl < 50 ml/min. CrCl of < 30 ml/min or dialysis dependence were defined as severe RI. The study cohort included 214 patients, 28 (13% patients with RI, including 11 patients severe RI (dialysis, n=1. Patients with RI were older, more likely to be female and had higher likelihood of having R-ISS stage 3 disease. Rates and severity of CRS (89% vs 84%, grade = 3: 7% vs 2% and ICANS (23% vs 20% were similar in patients with and without RI, respectively. Patients with RI had higher incidence of short-term = grade 3 cytopenias, although cytopenias were similar by 3 months following CAR-T. Renal function did not worsen after CAR-T in patients with RI. Response rates (93% vs 82% and survival outcomes (median PFS: 9 vs 8 months, p=0.26 were comparable in patients with and without RI, respectively. Treatment with ide-cel is feasible in patients with RI, with a comparable safety and efficacy profile as patients without RI, with notable exception of higher short-term high-grade cytopenias.

View details for DOI 10.3324/haematol.2023.283940

View details for PubMedID 37731379