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Idecabtagene vicleucel 用于复发/难治性多发性骨髓瘤:1 期试验的事后 18 个月随访

英文原题:Idecabtagene vicleucel for relapsed and refractory multiple myeloma: post hoc 18-month follow-up of a phase 1 trial.

查看英文原题

Idecabtagene vicleucel for relapsed and refractory multiple myeloma: post hoc 18-month follow-up of a phase 1 trial.

PubMed 2023/08/17(内容时间) Nat Med Q1 · IF 52.5(JCR 2025)

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中文摘要

Idecabtagene vicleucel(ide-cel)是一种靶向B细胞成熟抗原(BCMA)的CAR-T 细胞疗法。

我们对一项在复发/难治性多发性骨髓瘤中开展的单臂1期多中心研究(CRB-401)进行了事后分析(n = 62;中位随访时间18.1个月)。主要终点为安全性结局,次要终点包括总缓解率(ORR)、完全缓解(CR)和非常好的部分缓解(VGPR)。

该研究达到了主要终点,3级/4级细胞因子释放综合征(6.5%)和神经毒性(1.6%)发生率较低。ORR为75.8%;64.5%达到VGPR或更好,38.7%达到CR或严格CR。在探索性终点中,中位缓解持续时间、无进展生存期(PFS)和总生存期分别为10.3、8.8和34.2个月,ide-cel在外周血和骨髓中的扩增与临床疗效及输注后可溶性BCMA的降低相关。与缓解持续时间较短的患者相比,PFS ≥ 18个月的患者其单采材料中初始T细胞更多、耗竭T细胞更少,且药物产品中功能性T细胞表型更优。这些结果证实了ide-cel的安全性、耐受性和疗效,并描述了与持久缓解相关的T细胞质量。ClinicalTrials.gov标识符:NCT02658929。

展开英文摘要原文

Idecabtagene vicleucel (ide-cel) is a B-cell-maturation antigen (BCMA)-directed chimeric antigen receptor T cell therapy.

We performed a post hoc analysis of a single-arm phase 1 multicenter study in relapsed/refractory multiple myeloma (CRB-401) (n = 62; median follow-up, 18. 1 months). The primary endpoint was safety outcomes, and secondary endpoints included overall response rate (ORR), complete response (CR) and very good partial response (VGPR). The study met its primary endpoint with low rates of grade 3/grade 4 cytokine release syndrome (6. 5%) and neurotoxicity (1. 6%). ORR was 75. 8%; 64. 5% achieved VGPR or better and 38. 7% achieved CR or stringent CR.

Among exploratory endpoints, median duration of response, progression-free survival (PFS) and overall survival were 10. 3, 8. 8 and 34. 2 months, respectively, and ide-cel expansion in blood and bone marrow correlated with clinical efficacy and postinfusion reduction of soluble BCMA.

Patients with PFS ≥ 18 months had more naive and less exhausted T cells in apheresis material and improved functional T cell phenotype in the drug product compared with those with less durable responses. These results confirm ide-cel safety, tolerability and efficacy and describe T cell qualities that correlate with durable response. Clinicaltrials. gov identifier : NCT02658929 .

论文信息

作者
Lin Y、Raje NS、Berdeja JG、Siegel DS、Jagannath S、Madduri D、Liedtke M、Rosenblatt J
单位
Mayo Clinic, Rochester, MN, USA. lin.yi@mayo.edu.United States
文献类型
多中心研究 · I 期临床试验 · 非美国政府资助研究
期刊
Nature medicine2023 Sep
原文标识
PubMed 37592106 · DOI 10.1038/s41591-023-02496-0