Long-Term Data Support Cilta-Cel Use in R/R Multiple Myeloma: Sundar Jagannath, MBBS

In part 2 of an interview with The American Journal of Managed Care^® at the European Hematology Association 2025 Congress, Sundar Jagannath, MBBS, professor of medicine at the Icahn School of Medicine at Mount Sinai and investigator for the phase 1b/2 CARTITUDE-1 trial (NCT03548207), contextualizes the long-term follow-up results he described in part 1.

More specifically, he elaborates on how findings from his abstract, “Long-Term (≥5 Year) Remission and Survival After Treatment With Ciltacabtagene Autoleucel in CARTITUDE-1 Patients With Relapsed/Refractory Multiple Myeloma," advance the understanding of ciltacabtagene autoleucel (cilta-cel) as a potentially curative therapy for this patient population. Jagannath also discusses the implications for future research and patient care.

This transcript was lightly edited; captions were auto-generated.

Transcript

How do the long-term CARTITUDE-1 results advance the understanding of cilta-cel's potential as a curative therapy for patients with relapsed/refractory multiple myeloma? What are the implications for future patient care?

What [do] today's long-term results of CARTITUDE-1 mean to the patient? Number one, it tells the patient there is a potential cure for them. We have moved the needle in multiple myeloma from an incurable disease to a curable disease; that's very important. The second important point is, even in [patients with] late-stage [disease], as shown in CARTITUDE-1, where cilta-cell is available [worldwide], you can give CAR [cancer antigen receptor] T-cell and expect a potential cure. More importantly, we want to use this effective therapy earlier in the course of the disease.

The results of CARTITUDE-4 [were] also very encouraging. This was a randomized trial comparing [the] one-time infusion of cilta-cell with no further maintenance compared to standard chemotherapy, with daratumumab, pomalidomide, [and] dexamethasone, or velcade pomalidomide [and] dexamethasone until progression in patients who had 1 to 3 prior lines of therapy and whose disease was lenalidomide-refractory. Again, we do know the earlier results were so positive that the patient who received cilta-cell did remarkably well, so this is now approved in the United States and Europe for patients who had failed only one line of therapy.

Now, we have updated the results, with a median follow-up of 30 months. The results were updated, and what we see is, even by subset analysis, we show that the overall complete remission, MRD [minimal residual disease]-negative status, is noted in 80% of the patients who got cilta-cell vs only 30% who got standard of care and sustained MRD negativity at one year.

Over 50% of the patient who got cilta-cell had a sustained MRD negative status, with less than 10% of the patients [receiving the] standard of care. This is reflected in the better progression-free survival. The progression-free survival was superior against the standard of care treatment for [patients with] standard risk, high risk, [or] extramedullary disease. For every subset we analyze, it looks like receiving CAR T-cells, especially cilta-cell, is far better than standard of care.

Now, cilta-cel is being used in a clinical trial upfront, CARTITUDE-5 and CARTITUDE-6, where we are exploring cilta-cel, CAR T-cell administration vs standard of care. I hope in the future we'll find out [if] giving CAR T-cells earlier in the treatment paradigm will give patients deep remission, durable remission, and time off treatment, which is very important for patients. Up [until] now, in multiple myeloma, you always had to receive treatment continuously until progression, so their quality of life and the treatment burden is very high. Whereas, giving a CAR T-cell, one and done deal, is remarkable for patients because they feel liberated and they could enjoy their life. That is the unprecedented development in multiple myeloma.