多发性骨髓瘤患者接受 BCMA 特异性 CAR-T 治疗后挽救治疗的结局：LEGEND-2 回顾性分析

Chimeric antigen receptor T-cell (CAR-T) therapy targeting B-cell maturation antigen (BCMA) has shown profound efficacy and manageable toxicity in patients with relapsed/refractory multiple myeloma (RRMM).

However, determining the best course of treatment for post-CAR-T therapy relapse remains a significant challenge.

We conducted a retrospective analysis of patients from the phase I LEGEND-2 study (NCT03090659) enrolled at the Xi'an site, analysing the first salvage line of therapy and outcomes in patients with RRMM who progressed after receiving LCAR-B38M CAR-T therapy. Of 45 eligible patients, 34 (76%) had progressive disease (PD).

Overall response rate (ORR) to salvage treatment was 50. 0%. Median progression-free survival (PFS) after starting salvage treatment was 16. 3 months. Median PFS of patients receiving proteasome inhibitor (PI)-based combination therapy was longer (28.

2 months) than that of patients receiving a second BCMA CAR-T (including LCAR-B38M; 3. 9 months, p = 0. 0022) or chemotherapy (1. 67 months, p = 0. 0001). All patients with extramedullary disease at baseline (n = 11) progressed after CAR-T therapy; ORR to salvage therapy was 25. 0% and median PFS was 9. 7 months.

In conclusion, salvage therapy in patients with PD after receiving LCAR-B38M CAR-T cells produced moderate efficacy, with better outcomes for PI-based salvage regimens.