Fiche publication
Date publication
février 2026
Journal
Blood advances
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CAILLOT Denis
Tous les auteurs :
Cayla S, Karlin L, Lambert J, Lazareth A, Talbot A, Mohty M, Malard F, Petillon MO, Manier S, Yakoub-Agha I, Caillot D, Lafon I, Leleu X, Moya N, Royer B, Schiano De Colella JM, Brisou G, Touzeau C, Perrot A, Bories P, Vincent L, Guedon H, Decaux O, Ferment B, Houot R, Le Gouill S, Bigot N, Facon T, Corre J, Avet-Loiseau H, Moreau P, Arnulf B
Lien Pubmed
Résumé
Idecabtagene vicleucel (ide-cel), an adoptive chimeric antigen receptor T-cell therapy directed against B-cell maturation antigen (BCMA), has demonstrated high response rates and improved survival in patients with relapsed/refractory multiple myeloma. However, all patients eventually relapse, and data on salvage therapy outcomes remain limited. We conducted a national, real-world study of 154 patients relapsing after ide-cel, with a median time to progression of 6.0 months (interquartile range, 3.0-9.9). Salvage therapies included anti-BCMA bispecific antibodies (BsAbs) (n = 79), non-BCMA BsAbs targeting GPRC5D or FcRH5 (n = 12), combinations of immunomodulatory agent, proteasome inhibitor, and anti-CD38 monoclonal antibody (n = 40), and others (n = 23). Median overall survival (OS) was 12.12 months (95% confidence interval, 6.6 to not reached), and median progression-free survival (PFS) was 3.48 months (95% CI, 2.6-6.37). The overall response rate (≥ partial response) was higher in patients treated with BsAbs (36%) than others (13%, P = .002). Treatment with non-BCMA BsAbs resulted in significantly higher ORR (67% vs 30%, P = .018), OS (19.48 vs 8.41 months, P = .034) and PFS (9.2 vs 3.81 months, P = .035) compared to anti-BCMA BsAbs. Early relapse after ide-cel (≤6 months) was associated with worse outcomes (OS: 5.95 vs 12.58 months, P = .040), as was extramedullary disease (OS: 13.8 vs 6.28 months, P = .033) and exposure to >3 prior lines of therapy. In summary, anti-BCMA BsAbs offered limited efficacy whereas non-BCMA BsAbs may offer a promising therapeutic approach following ide-cel early relapse. These results underscore the potential benefits of diversifying targets in relapse post-ide-cel treatment strategies. This trial was registered at www.clinicaltrials.gov as #NCT04328298.
Mots clés
Humans, Antibodies, Bispecific, therapeutic use, Male, Female, Middle Aged, Aged, B-Cell Maturation Antigen, immunology, Multiple Myeloma, therapy, Recurrence, Treatment Outcome, France, Immunotherapy, Adoptive, methods, Salvage Therapy, Receptors, Chimeric Antigen
Référence
Blood Adv. 2026 02 24;10(4):1324-1333
