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3785 Racial and Ethnic Differences in Outcomes of Multiple Myeloma Patients Treated with Idecabtagene Vicleucel or Ciltacabtagene Autoleucel

Program: Oral and Poster Abstracts
Session: 907. Outcomes Research: Plasma Cell Disorders: Poster II
Hematology Disease Topics & Pathways:
Research, Adult, Epidemiology, Clinical Research, Plasma Cell Disorders, Health disparities research, Diseases, Real-world evidence, Lymphoid Malignancies, Study Population, Human
Sunday, December 8, 2024, 6:00 PM-8:00 PM

Lauren C. Peres, PhD, MPH1*, Alicia Richards, PhD1*, Surbhi Sidana, MD2, Laura B. Oswald, PhD3*, Danai Dima, MD4, Aimaz Afrough, MD5, Leyla O. Shune, MD6, Shonali Midha, MD7*, Omar Castaneda, MD8, Christopher Ferreri9, James A Davis, PharmD10*, Oren Pasvolsky, MD11, Christen M. Dillard, MD12, Megan M Herr, PhD13, Mehmet H. Kocoglu, MD14, Shebli Atrash, MD, MS9, Brandon Blue15, Evguenia Ouchveridze, MD16, Joseph P. McGuirk, DO17, Charlotte B Wagner, PharmD18*, Radhika Bansal, MBBS19*, Patrick Costello, MS7*, Kinaya Smith, MD20*, Alex Lieberman-Cribbin21*, Gabriel De Avila15*, Sneha Purvey, MD22, Hitomi Hosoya, MD, PhD23, Lekha Mikkilineni, MD, MA23, Gurbakhash Kaur, MD, MA24, Mahmoud R. Gaballa, MD25, Peter A. Forsberg, MD26, Ciara Louise Freeman, PhD, MSc, FRCPC, MRCP8, Murali Janakiram, MBBS27, Myo Htut, MD27, Sireesha Asoori, MBBS, MPH28*, Nilesh Kalariya, PhD, RN29*, Djordje Atanackovic, MD30, Binod Dhakal, MBBS31, Jack Khouri, MD32, Shahzad Raza, MD4, Ran Reshef, MD, MSc33, Melissa Alsina, MD34, Frederick L. Locke, MD35, Omar Nadeem, MD36, Faiz Anwer, MD4, Larry D Anderson Jr., MD, PhD37, Shambavi Richard, MD21, Yi Lin, MD, PhD38, Thomas Martin, MD28, Peter M. Voorhees, MD39, Krina K. Patel, MD, MSc11, Doris K. Hansen, MD8 and Douglas W Sborov, MD40

1Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
2Stanford University School of Medicine, Stanford, CA
3Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
4Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
5Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Coppell, TX
6Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas, Westwood, KS
7Dana-Farber Cancer Institute, Boston, MA
8Department of Blood and Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
9Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
10Division of Hematology-Oncology, Medical University of South Carolina, Charleston, SC
11Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
12Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
13Roswell Park Comprehensive Cancer Center, Buffalo, NY
14University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD
15H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
16University of Kansas Medical Center, Kansas City, KS
17Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Ctr., Westwood, KS
18Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
19Division of Hematology, Mayo Clinic, Bismarck, ND
20Medical College of Wisconsin, Milwaukee, WI
21Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
22Virginia Commonwealth University, Richmond, VA
23Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Palo Alto, CA
24Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
25The University of Texas MD Anderson Cancer Center, Houston, TX
26University of Colorado Cancer Center, Denver, CO
27Judy and Bernard Briskin Center for Multiple Myeloma Research, City of Hope, Duarte, CA
28UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
29Department of Lymphoma & Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
30University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD
31Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
32Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
33Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
34Moffitt Cancer Center, Tampa, FL
35Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
36Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
37Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX
38Division of Hematology, Mayo Clinic, Rochester, MN
39Plasma Cell Disorders Section, Department of Hematologic Oncology & Blood Disorders, Levine Cancer Center, Charlotte, NC
40Huntsman Cancer Institute, University of Utah, Salt Lake City, UT

*Authors contributed equally.

Introduction. Two chimeric antigen receptor (CAR) T-cell therapies have been FDA approved for patients with relapsed/refractory multiple myeloma (RRMM): idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel). Prior work from our consortium identified racial and ethnic differences in safety and response to ide-cel among patients treated in the standard of care (SOC) setting; despite these differences, survival was similar across race and ethnicity. Here, we extend this work to investigate racial and ethnic differences in safety, efficacy, and outcomes in a larger cohort of patients treated with SOC ide-cel with longer follow-up and patients treated with SOC cilta-cel.

Methods. Data for RRMM patients who underwent leukapheresis by 12/31/2022 and were treated with SOC ide-cel or cilta-cel were pooled across 19 institutions in the U.S. Multiple Myeloma Immunotherapy Consortium. We compared Non-Hispanic White, Non-Hispanic Black, and Hispanic (any race) patients, excluding other racial and ethnic groups due to small sample sizes that precluded sub-group investigations. Separately for each CAR T-cell therapy, racial and ethnic differences in baseline patient characteristics, safety, and treatment responses were examined using chi-square and Kruskal-Wallis rank sum tests. Kaplan-Meier survival curves and log-rank tests were used to examine progression-free survival (PFS) and overall survival (OS) by race and ethnicity.

Results. Among 332 RRMM patients treated with ide-cel, Non-Hispanic Black and Hispanic patients comprised 17% and 10% of the cohort, respectively. Hispanic patients were younger at infusion compared to Non-Hispanic Black and Non-Hispanic White patients (55.5 vs. 63 vs. 66 years, p<0.001). Non-Hispanic Black patients had a higher disease burden (≥ 50% bone marrow plasma cell percentage) compared to Non-Hispanic White and Hispanic patients (35% vs. 20% vs. 19%, p=0.05), while a higher proportion of Non-Hispanic White patients had high-risk cytogenetics compared to Non-Hispanic Black and Hispanic patients (37% vs. 23% vs. 10%, p=0.003). Non-Hispanic Black patients were more likely to develop severe (≥ grade 3) cytopenia at day 30 (p<0.001) and day 90 (p=0.01) post-infusion, and these differences were particularly driven by higher rates of severe neutropenia among Non-Hispanic Black patients at these time points. Non-Hispanic White patients were more likely to achieve a best response of partial response (PR) or better (82%) compared to Non-Hispanic Black (75%) and Hispanic patients (63%, p=0.02). No other racial and ethnic differences in baseline patient characteristics (including cytopenias), safety, PFS, and OS were observed (p>0.05).

Among 222 RRMM patients treated with cilta-cel, Non-Hispanic Black and Hispanic patients comprised 12% and 9% of the cohort, respectively. At baseline, Non-Hispanic Black and Hispanic patients were more likely to have anemia (p=0.01), and Non-Hispanic Black patients were more likely to have thrombocytopenia (p=0.02) and neutropenia (p=0.06) compared to Non-Hispanic White patients. No other differences in baseline patient characteristics were observed by race and ethnicity. While not statistically significant, a higher rate of severe (≥ grade 3) cytopenia at day 90 post-infusion was observed among Non-Hispanic Black and Hispanic patients compared to Non-Hispanic White patients (33% vs. 44% vs. 21%, p=0.07), similar to the ide-cel cohort. This finding was primarily driven by higher rates of severe neutropenia among Non-Hispanic Black patients and higher rates of anemia among Hispanic patients. No other racial and ethnic differences in safety, responses to cilta-cel, PFS, or OS were not observed in the cilta-cel cohort (p>0.05).

Conclusion. In a large cohort of RRMM patients treated with SOC ide-cel or cilta-cel, we observed a higher rate of cytopenias post-infusion and inferior ide-cel responses among racial and ethnic minority patients compared to Non-Hispanic White patients. Despite these differences, survival was similar across race and ethnicity, suggesting that both available CAR T-cell therapies for RRMM patients can be utilized across all populations. Future studies that include larger patient cohorts of racially and ethnically diverse patients should be conducted to confirm these findings and additionally evaluate long-term outcomes.

Disclosures: Peres: Bristol Myers Squibb: Research Funding; Karyopharm Therapeutics: Research Funding. Sidana: Regeneron: Consultancy; BiolineRx: Consultancy; Legend: Consultancy; Takeda: Consultancy; Oncopeptides: Consultancy; Janssen: Consultancy, Research Funding; Abbvie: Consultancy; Pfizer: Consultancy; Sanofi: Consultancy; Novartis: Research Funding; Kite, A Gilead company: Consultancy; BMS: Consultancy, Research Funding. Afrough: K36 Therapeutics: Research Funding; Bristol-Myers Squibb: Honoraria, Other; Karyopharm Therapeutics: Honoraria, Other; Sanofi: Honoraria, Other; Adaptive Biotech: Research Funding; Abbvie: Research Funding. Shune: BMS: Membership on an entity's Board of Directors or advisory committees; Norvatis: Membership on an entity's Board of Directors or advisory committees; Johnson and Johnson: Membership on an entity's Board of Directors or advisory committees. Midha: Janssen: Consultancy; Pfizer: Consultancy. Castaneda: BMS: Consultancy; Janssen: Consultancy; Legend Biotech: Consultancy. Ferreri: Sanofi: Consultancy; Janssen: Consultancy; Affimed Therapeutics.: Current equity holder in private company. Davis: Janssen Biotech: Speakers Bureau. Blue: Sanofi: Speakers Bureau; Pfizer Pharmaceuticals, Oncopeptides, Takeda, Abbvie, Janssen, and Kite Pharmaceuticals: Consultancy. McGuirk: Sana technologies: Consultancy; Caribou bio: Consultancy; CRISPR therapeutics: Consultancy; NEKTAR therapeutics: Consultancy; Autolus: Consultancy; Envision: Consultancy; Allo Vir: Consultancy; Novartis: Consultancy; Kite: Consultancy; BMS: Consultancy; Legend biotech: Consultancy. Wagner: Pfizer: Consultancy; Jazz: Research Funding. Bansal: Kite Pharma: Other: Travel Support. Mikkilineni: Legend Biotech: Consultancy, Other: advisory board at ASH December 2023; BiolineRx: Consultancy, Other: advisory board at ASH December 2023. Kaur: Pfizer: Consultancy, Honoraria; Arcellx: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Kedrion: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Kite, a Gilead Company: Consultancy, Membership on an entity's Board of Directors or advisory committees; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Cellectar Biosciences: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; AbbVie: Research Funding. Gaballa: Boxer Capital, LLC: Consultancy; GLG: Consultancy; Guidepoint: Consultancy; Bristol Myers Squibb: Consultancy. Forsberg: University of Colorado: Ended employment in the past 24 months; Sanofi: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Johnson and Johnson, BMS: Membership on an entity's Board of Directors or advisory committees; Colorado Blood Cancer Institute: Current Employment; Karyopharm: Research Funding. Freeman: Incyte: Consultancy; Sanofi: Consultancy; Seattle Genetics: Consultancy; Abbvie: Consultancy; BMS: Consultancy, Honoraria, Research Funding; Celgene: Consultancy; Janssen: Consultancy, Research Funding; Amgen: Consultancy; ONK therapeutics: Consultancy; Roche/Genentech: Research Funding. Janakiram: FATE THERAPEUTICS: Research Funding; JANNSEN: Honoraria, Research Funding; BMS: Honoraria, Research Funding; LEGEND: Honoraria, Research Funding. Dhakal: Acrellx: Research Funding; Sanofi: Research Funding; Genentech: Consultancy, Honoraria; C4 therapeutics: Research Funding; Bristol Myers Squibb: Honoraria, Research Funding; Medical College of Wisconsin: Current Employment; Carsgen: Research Funding; Pfizer: Consultancy, Honoraria, Speakers Bureau; Karyopharm: Honoraria, Speakers Bureau; Janssen: Honoraria, Research Funding, Speakers Bureau. Khouri: Janssen: Consultancy; Legend Biotech: Honoraria; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees; GPCR Therapeutics: Honoraria. Raza: Pfizer: Consultancy, Honoraria; Prothena Biosciences: Consultancy; Kite Pharma: Consultancy. Reshef: Sana Biotechnology: Consultancy; Sanofi: Research Funding; Bayer: Consultancy; J&J: Research Funding; Takeda: Research Funding; Immatics: Research Funding; BMS: Research Funding; Synthekine: Research Funding; Cabaletta: Research Funding; Atara Biotherapeutics: Research Funding; Genentech: Research Funding; TCR2: Research Funding; Abbvie: Research Funding; Precision Biosciences: Research Funding; Quell Biotherapeutics: Consultancy; Autolus: Consultancy; Gilead Sciences: Consultancy, Research Funding; Incyte: Consultancy, Research Funding; TScan: Consultancy, Research Funding; Orca Bio: Consultancy; CareDx: Research Funding; Allogene: Consultancy. Alsina: Janssen: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding; Sanofi: Membership on an entity's Board of Directors or advisory committees. Locke: GammaDelta Therapeutics: Consultancy; Amgen: Consultancy; Emerging Therapy Solutions Gerson Lehman Group: Consultancy; Iovance: Consultancy; Bluebird Bio: Consultancy, Research Funding; Calibr: Consultancy; Cowen: Consultancy; Cellular Biomedicine Group: Consultancy; Janssen: Consultancy; Kite, a Gilead Company: Consultancy, Other: Travel support, Research Funding; BMS: Consultancy, Research Funding; Celgene: Consultancy; 2SeventyBio: Research Funding; CERo Therapeutics: Research Funding; Pfizer: Consultancy; Sana: Consultancy; Gerson Lehrman Group (GLG): Consultancy; Caribou: Consultancy; A2: Consultancy; Society for Immunotherapy of Cancer: Honoraria; iMedX: Honoraria; Clinical Care Options Oncology: Honoraria; Communications CARE Education: Honoraria; BioPharma: Honoraria; ASH: Honoraria, Other: Travel support; Aptitude Health: Honoraria; Moffit Cancer Center: Patents & Royalties: cellular immunotherapy; Umoja: Consultancy; Novartis: Consultancy, Research Funding; Legend Biotech: Consultancy; Gilead Company: Consultancy; Allogene: Consultancy, Research Funding; Wugen: Consultancy; ecoR1: Consultancy; National Cancer Institute: Research Funding; Leukemia and Lymphoma Society Scholar in Clinical Research: Research Funding; Aptitude Health: Honoraria. Nadeem: BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding; GPCR Therapeutics: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees, Research Funding; JNJ: Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Sanofi: Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria. Anwer: BMS: Consultancy. Anderson: AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Cellectar Biosciences: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Beigene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; GSK: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Prothena: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: DSMB; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS: Consultancy, Honoraria, Other: Travel Expenses, Research Funding. Richard: Heidelberg Pharma: Research Funding; C4 Therapeutics: Research Funding; Gracell Therapeutics: Other: Steering Committee, Research Funding; Genentech: Membership on an entity's Board of Directors or advisory committees; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Steering Committee, Research Funding; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Lin: Janssen: Consultancy, Research Funding; NexImmune: Membership on an entity's Board of Directors or advisory committees; Sanofi: Consultancy; Pfizer: Membership on an entity's Board of Directors or advisory committees; Genentech: Consultancy; Regeneron: Consultancy; Celgene: Consultancy, Research Funding; Legend: Consultancy; Caribou: Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Consultancy, Research Funding. Martin: AMGEN: Research Funding; Janssen: Research Funding; BMS: Research Funding; Sanofi: Research Funding; Pfizer: Honoraria; Roche: Honoraria; GSK: Honoraria. Voorhees: Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Regeneron: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Lava Therapeutics: Consultancy; GSK: Consultancy, Research Funding; Karyopharm: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy; Janssen: Consultancy, Research Funding. Patel: Merck: Consultancy; Abbvie: Consultancy; Sanofi: Consultancy; Pfizer: Consultancy; Takeda: Consultancy; Oricel: Consultancy, Other: Chair of scientific board; Kite, A Gilead company: Consultancy, Other: scientific advisory board; AstraZeneca: Consultancy; Johnson & Johnson (Janssen): Consultancy; BMS: Consultancy, Other: chair of scientific advisory board ; Genentech: Consultancy; Caribou Sciences: Consultancy; Poseida: Consultancy. Hansen: Karyopharm: Consultancy, Research Funding; Pfizer: Consultancy; BMS: Consultancy, Research Funding; Janssen: Consultancy. Sborov: GlaxoSmithKline: Consultancy; Legend Biotech: Consultancy; Bristol Myers Squibb: Consultancy; Sanofi: Consultancy; Abbvie: Consultancy; University of Utah, Huntsman Cancer Institute: Current Employment; Genentech, Inc.: Consultancy; Society of Utah Medical Oncology: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy; Janssen: Consultancy; Pfizer: Consultancy, Research Funding; Bioline: Consultancy; Arcellx: Consultancy; Binaytara Foundation: Honoraria; Parexel, Keosys: Other: IRC.

*signifies non-member of ASH