There are no differences in survival between people of different ethnicities being treated with chimeric antigen receptor (CAR) T-cell therapy for relapsed/refractory multiple myeloma, according to a new analysis.
The US study, published in Blood Advances, reports that race and ethnicity make no difference to survival outcomes for patients treated with idecabtagene vicleucel, or ide-cel. This should reassure patients, according to lead author Dr Laura Peres.
“With this study, we see that Black and white patients with multiple myeloma both respond well to ide-cel,” said Dr Peres, an epidemiologist at Moffit Cancer Center, Tampa, Florida. “We hope that these findings encourage the use of ide-cel in all patients with multiple myeloma.”
In 2021, ide-cel became the first CAR T-cell therapy to gain approval from the U.S. Food and Drug Administration (FDA) to treat relapsed/refractory multiple myeloma. A decision from NICE for use on the NHS is still pending.
The US team wanted to examine how outcomes differ between racial and ethnic groups. Dr Peres and her research team collected data from 207 patients at 11 institutions that participated in the U.S. Multiple Myeloma Immunotherapy Consortium.
Of the patients included in the study, 149 (72%) were non-Hispanic white, 30 (17%) were non-Hispanic Black and 22 (11%) were Hispanic.
The researchers looked retrospectively at remission rates, overall survival, and the prevalence of complications associated with CAR T-cells, based upon a follow up of about nine months after treatment.
Non-Hispanic Black patients were more likely to develop cytokine release syndrome than Hispanic and non-Hispanic white patients (97% compared to 77% and 85% respectively).
However, there were no significant differences in one group’s likelihood of developing severe complications. Neither were there significant differences in the incidence of intensive care unit admission, likelihood of reaching complete remission, or overall survival between the different ethnic groups, the researchers report.
While the overall response rate was lower among Hispanic patients compared with non-Hispanic Black and white patients, the team believe this could in part be attributed to the limited number of Hispanic patients included in the study.
“These results highlight the need for diverse patient cohorts in research and clinical trials,” said Dr Peres.
“Clinical trials often lack diversity for many reasons such as recruitment barriers, financial considerations, medical mistrust, and cultural insensitivity. But stringent trial eligibility criteria also often exclude racial and ethnic minorities.
“In fact, 75% of our study population would not have been eligible for the trial that led to FDA approval of ide-cel. A lack of clinical trial representation can limit underrepresented groups’ access to life-saving care.”
Peres LC, Oswald LB, Dillard CM, De Avila G, Nishihori T, Blue BJ, Freeman CL, Locke FL, Alsina M, Castaneda Puglianini OA, Shune L, Sborov DW, Wagner C, Dima D, Hashmi H, Davis JA, Kocoglu MH, Badros AZ, Atrash S, Simmons G, Kalariya N, Ferreri CJ, Anderson LD Jr, Afrough A, Kaur G, Lin Y, Liu L, Nadeem O, Voorhees PM, Khouri J, McGuirk JP, Sidana S, Hansen DK, Patel KK. (2023) “Racial and ethnic differences in clinical outcomes among multiple myeloma patients treated with CAR T-cell therapy.” Blood Advances, doi: 10.1182/bloodadvances.2023010894
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