Overview of iMMagine-1 Trial: Phase 2 Registrational Study of Anitocabtagene Autoleucel for the Treatment of R/R MM

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IMMagine-1 Phase 2 Study of Anitocabtagene Autoleucel in R/R MM


The iMMagine-1 trial evaluates anitocabtagene autoleucel (anti-BCMA chimeric antigen receptor [CAR] T-cell therapy) in patients with R/R MM. Preliminary results focus on efficacy and safety in heavily pretreated patients, including those refractory to triple-class (proteasome inhibitors, immunomodulatory agents, and anti-CD38 monoclonal antibodies) and penta-class therapies.

High response rates were observed, even in penta-refractory patients, suggesting durable disease control in a population with limited treatment options.

Depth of response correlated with improved progression-free survival, reinforcing the potential of BCMA-targeted CAR T therapy in later-line settings.

Toxicities were consistent with prior CAR T therapies, including cytokine release syndrome and neurotoxicity, but were generally manageable.

Further follow-up is needed to assess long-term safety and durability of responses.

The efficacy in triple- and penta-refractory patients may shift treatment paradigms, positioning BCMA-targeted CAR T therapy earlier in the disease course.

Potential integration into sequencing strategies for R/R MM, especially in those failing standard regimens

These results reinforce the role of CAR T therapies in overcoming resistance mechanisms in heavily pretreated myeloma.

The durability of response may challenge the reliance on continuous therapy models, offering the possibility of fixed-duration treatment with sustained benefit.

Optimization of patient selection and bridging strategies

Comparative studies with bispecific antibodies and other emerging BCMA-directed therapies

These findings highlight anitocabtagene autoleucel as a promising therapeutic option in the evolving R/R MM landscape, warranting continued investigation in larger cohorts.

Videos

Panelists discuss how the preliminary results from the iMMagine-1 trial of anitocabtagene autoleucel in relapsed/refractory multiple myeloma (R/R MM) highlight promising efficacy in triple-class and penta-class refractory patients, potentially reshaping treatment strategies and challenging existing paradigms in managing heavily pretreated myeloma.

Application of Real-World Evidence in Selecting CAR T in R/R MM

Chimeric Antigen Receptor (CAR) T-Cell Therapy in R/R MM

Panelists discuss how real-world comparative analyses reveal nuanced differences in the efficacy and safety profiles of ciltacabtagene autoleucel and idecabtagene vicleucel among patients with R/R MM, highlighting the critical importance of translating clinical trial data into practical treatment strategies.

The retrospective intention-to-treat analysis by Amoozgar et al presented at ASH 2024 (abstract #2408) offers several important perspectives:

: Real-world studies demonstrate that CAR T-cell therapy outcomes can differ significantly from controlled clinical trial settings due to patient heterogeneity, comorbidities, and prior treatment histories.

: The study likely compared the efficacy and safety of 2 different CAR T-cell therapies (ciltacabtagene autoleucel and idecabtagene vicleucel) in actual clinical practice.

: Real-world data help refine patient selection criteria and predict more personalized treatment responses beyond initial clinical trial parameters.

: The analysis would have shed light on potential adverse events, treatment-related complications, and long-term tolerability in a more diverse patient population.

Panelists discuss how real-world comparative analyses reveal nuanced differences in the efficacy and safety profiles of ciltacabtagene autoleucel and idecabtagene vicleucel among patients with relapsed/refractory multiple myeloma (R/R MM), highlighting the critical importance of translating clinical trial data into practical treatment strategies.

Panelists discuss how real-world analyses of chimeric antigen receptor (CAR) T-cell therapies in relapsed/refractory multiple myeloma (R/R MM), as presented in abstract #2408 by Amoozgar et al at ASH 2024, provide insights into the comparative efficacy and safety of ciltacabtagene autoleucel and idecabtagene vicleucel, highlighting differences between real-world outcomes and clinical trial results.

Insights From the Comparative Efficacy and Safety of Ciltacabtagene Autoleucel and Idecabtagene Vicleucel in Real-World Relapsed/Refractory Multiple Myeloma: A Retrospective Intention-to-Treat Analysis

CAR T-Cell Therapies in R/R Multiple Myeloma: Real-World Insights

This retrospective intention-to-treat analysis compared the real-world efficacy and safety of 2 CAR T-cell therapies: ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) in R/R MM.

Evaluated real-world outcomes to bridge the gap between controlled clinical trials and actual patient experiences

Aimed to understand how these therapies perform in a more diverse, less controlled patient population

Comparative effectiveness of 2 different CAR T-cell approaches

Practical considerations for treatment selection

Patient outcomes outside of strict clinical trial protocols

Helps physicians make more informed treatment decisions

Offers a more nuanced understanding of CAR T-cell therapy performance in R/R MM

Panelists discuss how key data from ASH 2024 impact current approaches to treating hematologic malignancies, with a focus on multiple myeloma, lymphoma, and leukemia.

Welcome to This OncLive Peer Exchange: Highlighting Key Abstracts From ASH 2024

ASH 2024 Oncology Highlights for Physicians: Multiple Myeloma CAR T-Cell Therapy

 Peer Exchange focused on key data presented at the American Society of Hematology (ASH) 2024 Annual Meeting. The panel features experts:

The discussion aims to highlight significant abstracts and foster expert dialogue on recent developments in hematologic malignancies, specifically focusing on lymphoma, leukemia, and multiple myeloma.

The first abstract (#2408) under discussion examines real-world data comparing ciltacabtagene autoleucel (cilta-cel) vs idecabtagene vicleucel (ide-cel) in patients with relapsed multiple myeloma. Dr Parmar is invited to provide insights on how this real-world evidence might inform clinical decision-making for patients with multiple myeloma and potentially influence treatment selection between these 2 chimeric antigen receptor (CAR) T-cell therapies.

The discussion emphasizes the value of real-world data in understanding how approved therapies perform in clinical practice outside the controlled environment of clinical trials.

Jamie Koprivnikar, MD, medical oncologist, John Theurer Cancer Center, discusses FLT3 inhibitors in the treatment of hematologic malignancies.

FLT3 inhibitors are often associated with acute myeloid leukemia (AML), but they are being looked at in other hematologic malignancies as well. A phase II trial looked at untreated patients over the age of 60 who had

-mutated ITD-positive myelodysplastic syndrome (MDS), chronic myeloid leukemia (CML), or AML. This trial looked at quizartinib in combination with either azacitidine (Vidaza) or low-dose cytarabine. Promising responses were observed in patients who were previously untreated, with 11 out of 12 patients responding. Overall survival in this population was 18.6 months.

Interestingly, in the previously treated cohort, 5 patients had seen prior exposure to FLT3 inhibitors. This did not affect response, Koprivnikar explained, as 4 out of 5 (80%) of these patients still responded to the combination with quizartinib. An overall response rate of 68% was observed in this previously-treated population, with a median overall survival of 11.2 months.

Finding the optimal FLT3 inhibitor for each particular subgroup will be a continuing area of investigation, says Koprivnikar, as these agents are showing improvements in outcome.

Jamie Koprivnikar, MD, medical oncologist, John Theurer Cancer Center, discusses FLT3 inhibitors in the treatment of hematologic malignancies.
 

Jamie Koprivnikar, MD

Articles

Overview of iMMagine-1 Trial: Phase 2 Registrational Study of Anitocabtagene Autoleucel for the Treatment of R/R MM

Application of Real-World Evidence in Selecting CAR T in R/R MM

Insights From the Comparative Efficacy and Safety of Ciltacabtagene Autoleucel and Idecabtagene Vicleucel in Real-World Relapsed/Refractory Multiple Myeloma: A Retrospective Intention-to-Treat Analysis

Welcome to This OncLive Peer Exchange: Highlighting Key Abstracts From ASH 2024

Dr. Koprivnikar Discusses FLT3 Inhibitors in Hematologic Malignancies