接受 CAR-T 细胞治疗的多发性骨髓瘤患者临床结局的种族与族裔差异

Idecabtagene vicleucel (ide-cel) was the first chimeric antigen receptor T-cell therapy to gain US Food and Drug Administration 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 patients with RRMM (28% patients of racial and ethnic minority groups) 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 patients with RRMM. Compared with 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 = . 02) and baseline ferritin (362. 0 vs 307. 0 vs 680.

5, respectively; P = . 08) and were more likely to develop cytokine release syndrome (77%, 85%, and 97%, respectively; P = . 04). Although best overall response rate was lower among Hispanic patients (59%) than among non-Hispanic Black (86%) and White patients (86%; P = . 01), there were no racial and ethnic differences in progression-free or overall survival.

We provide, to our knowledge, 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 patients with RRMM.

These findings should be confirmed in larger samples of diverse patients with RRMM, with longer follow-up time.