June 13, 2021
Cilta-cel seems to have the edge over ide-cel, but with differing toxicities
- The CARTITUDE and KarMMa studies evaluated the safety and efficacy of two CAR T-cell therapies — ciltacabtagene autoleucel (cilta-cel) and vicleucel (ide-cel)
- Cilta-cel had the higher response rate, but neurotoxicity differed in the two therapies
- Deciding which of the two treatments to choose may come down to insurance coverage and availability of manufacturing slots
Two new studies show impressive results for two investigational CAR T-cell therapies, vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) in heavily pretreated patients with multiple myeloma. But when evaluating the two trials, which therapy comes out ahead?
“Comparing the CARTITUDE data to the KarMMa data, you can’t really beat a 98% response rate. So I think it’s at least likely that cilta-cel may be a bit more potent,” Dr. Clifton Mo, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet Connect during a virtual forum from the 2021 ASCO Annual Meeting.
The safety profile is one distinguishing factor between the two therapies. Neurotoxicity with cilta-cel was delayed by seven days, “which does make it more amenable to outpatient administration, especially for Medicare patients where reimbursement requires 72 hours of outpatient stay before hospitalization and reimbursement,” says Dr. Ravi Vij, professor of medicine at Washington University School of Medicine in St. Louis.
Dr. Saad Usmani, director of clinical research at Levine Cancer Institute in North Carolina, agrees that cilta-cel appears to be the dominant of the two therapies. He says insurance coverage and the availability of manufacturing slots might ultimately dictate which of the two treatments doctors choose. “I am concerned about the bottleneck in the manufacturing slots,” he tells SurvivorNet Connect. “We will simply be trying to get whichever manufacturing slot is available for our patients.”