Racial and ethnic differences in clinical outcomes among patients with multiple myeloma treated with CAR T-cell therapy

Abstract

Idecabtagene vicleucel (ide-cel) was the first chimeric antigen receptor T-cell therapy to gain FDA approval for patients with relapsed/refractory multiple myeloma (RRMM). The clinical outcomes of standard of care (SOC) ide-cel in racially and ethnically diverse populations have been understudied. This study pooled data from 207 RRMM patients (28% racial and ethnic minority patients) treated with SOC ide-cel across 11 institutions to examine racial and ethnic differences in the incidence of toxicities and adverse events, response to ide-cel, and survival. This study included 22 (11%) Hispanic, 36 (17%) Non-Hispanic Black, and 149 (72%) Non-Hispanic White RRMM patients. Compared to Hispanic and Non-Hispanic White patients, Non-Hispanic Black patients had higher median levels of C-reactive protein (1.0, 0.8, and 3.5 mg/dL, respectively; P=0.02) and baseline ferritin (362.0 vs. 307.0 vs. 680.5, respectively; P=0.08) and were more likely to develop cytokine release syndrome (77%, 85%, and 97%, respectively; P=0.04). Although best overall response rate was lower among Hispanic patients (59%) compared to Non-Hispanic Black (86%) and White patients (86%; P=0.01), there were no racial and ethnic differences in progression-free or overall survival. We provide the first and largest investigation of clinical outcomes of SOC ide-cel by race and ethnicity. Despite differences in safety and response to ide-cel, our findings encourage the use of ide-cel in all RRMM patients. These findings should be confirmed in larger samples of diverse RRMM patients with longer follow-up time.

Shrinking the divide: improving myeloma CART access

“…In this issue of Blood Ad vances , Peres et al authored the manuscript "Racial and ethnic differences in clinical outcomes among patients with multiple myeloma treated with CAR T-cell therapy." 1 Our commentary provides a broader context to the relevance of the findings and the potential implications of these results in reducing health care disparities. For any given disease, the disparities are more pronounced when the therapies for treating the disease are highly effective.…”