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Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma
Idecabtagene vicleucel (ide-cel) is a type of B-cell maturation antigen (BCMA)–targeting chimeric antigen receptor T-cell (CAR-T) approved for the treatment of relapsed and refractory multiple myeloma (RRMM). Currently, the incidence of cardiac events associated with ide-cel remains unclear. This wa...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The American Society of Hematology
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424134/ https://www.ncbi.nlm.nih.gov/pubmed/37307173 http://dx.doi.org/10.1182/bloodadvances.2023009766 |
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author | Lee, Dae Hyun Kumar, Abhishek Mohammed, Turab Peres, Lauren C. Alsina, Melissa Bachmeier, Christina Blue, Brandon J. Brayer, Jason Chandrasekhar, Sanjay Grajales Cruz, Ariel De Avila, Gabe Elmariah, Hany Faramand, Rawan Freeman, Ciara Jain, Michael Khadka, Sushmita Khimani, Farhad Liu, Hien Nishihori, Taiga Oswald, Laura B. Castaneda Puglianini, Omar A. Shain, Kenneth H. Smith, Eric Baz, Rachid C. Locke, Frederick L. Oliveira, Guilherme H. Alomar, Mohammed Hansen, Doris K. |
author_facet | Lee, Dae Hyun Kumar, Abhishek Mohammed, Turab Peres, Lauren C. Alsina, Melissa Bachmeier, Christina Blue, Brandon J. Brayer, Jason Chandrasekhar, Sanjay Grajales Cruz, Ariel De Avila, Gabe Elmariah, Hany Faramand, Rawan Freeman, Ciara Jain, Michael Khadka, Sushmita Khimani, Farhad Liu, Hien Nishihori, Taiga Oswald, Laura B. Castaneda Puglianini, Omar A. Shain, Kenneth H. Smith, Eric Baz, Rachid C. Locke, Frederick L. Oliveira, Guilherme H. Alomar, Mohammed Hansen, Doris K. |
author_sort | Lee, Dae Hyun |
collection | PubMed |
description | Idecabtagene vicleucel (ide-cel) is a type of B-cell maturation antigen (BCMA)–targeting chimeric antigen receptor T-cell (CAR-T) approved for the treatment of relapsed and refractory multiple myeloma (RRMM). Currently, the incidence of cardiac events associated with ide-cel remains unclear. This was a retrospective single-center observational study of patients treated with ide-cel for RRMM. We included all consecutive patients who received standard-of-care ide-cel treatment at least 1-month follow-up. Baseline clinical risk factors, safety profile, and responses were examined based on the development of a cardiac event. A total of 78 patients were treated with ide-cel, and 11 patients (14.1%) developed cardiac events: heart failure (5.1%), atrial fibrillation (10.3%), nonsustained ventricular tachycardia (3.8%), and cardiovascular death (1.3%). Only 11 of the 78 patients had repeat echocardiogram. Baseline risk factors associated with the development of cardiac events included being female sex and having poor performance status, λ light-chain disease, and advanced Revised International Staging System stage. Baseline cardiac characteristics were not associated with cardiac events. During index hospitalization after CAR-T, higher-grade (≥grade 2) cytokine release syndrome (CRS) and immune cell–associated neurologic syndrome were associated with cardiac events. In multivariable analyses, the hazard ratio for the association of the presence of cardiac events with overall survival (OS) was 2.66 and progression-free survival (PFS) was 1.98. Ide-cel CAR-T for RRMM was associated with similar cardiac events as other types of CAR-T. Worse baseline performance status and higher-grade CRS and neurotoxicity were associated with cardiac events after BCMA-directed CAR-T-cell therapy. Our results suggest that the presence of cardiac events may confer worse PFS or OS; although because of the small sample size, the power to detect an association was limited. |
format | Online Article Text |
id | pubmed-10424134 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The American Society of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-104241342023-08-15 Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma Lee, Dae Hyun Kumar, Abhishek Mohammed, Turab Peres, Lauren C. Alsina, Melissa Bachmeier, Christina Blue, Brandon J. Brayer, Jason Chandrasekhar, Sanjay Grajales Cruz, Ariel De Avila, Gabe Elmariah, Hany Faramand, Rawan Freeman, Ciara Jain, Michael Khadka, Sushmita Khimani, Farhad Liu, Hien Nishihori, Taiga Oswald, Laura B. Castaneda Puglianini, Omar A. Shain, Kenneth H. Smith, Eric Baz, Rachid C. Locke, Frederick L. Oliveira, Guilherme H. Alomar, Mohammed Hansen, Doris K. Blood Adv Clinical Trials and Observations Idecabtagene vicleucel (ide-cel) is a type of B-cell maturation antigen (BCMA)–targeting chimeric antigen receptor T-cell (CAR-T) approved for the treatment of relapsed and refractory multiple myeloma (RRMM). Currently, the incidence of cardiac events associated with ide-cel remains unclear. This was a retrospective single-center observational study of patients treated with ide-cel for RRMM. We included all consecutive patients who received standard-of-care ide-cel treatment at least 1-month follow-up. Baseline clinical risk factors, safety profile, and responses were examined based on the development of a cardiac event. A total of 78 patients were treated with ide-cel, and 11 patients (14.1%) developed cardiac events: heart failure (5.1%), atrial fibrillation (10.3%), nonsustained ventricular tachycardia (3.8%), and cardiovascular death (1.3%). Only 11 of the 78 patients had repeat echocardiogram. Baseline risk factors associated with the development of cardiac events included being female sex and having poor performance status, λ light-chain disease, and advanced Revised International Staging System stage. Baseline cardiac characteristics were not associated with cardiac events. During index hospitalization after CAR-T, higher-grade (≥grade 2) cytokine release syndrome (CRS) and immune cell–associated neurologic syndrome were associated with cardiac events. In multivariable analyses, the hazard ratio for the association of the presence of cardiac events with overall survival (OS) was 2.66 and progression-free survival (PFS) was 1.98. Ide-cel CAR-T for RRMM was associated with similar cardiac events as other types of CAR-T. Worse baseline performance status and higher-grade CRS and neurotoxicity were associated with cardiac events after BCMA-directed CAR-T-cell therapy. Our results suggest that the presence of cardiac events may confer worse PFS or OS; although because of the small sample size, the power to detect an association was limited. The American Society of Hematology 2023-06-15 /pmc/articles/PMC10424134/ /pubmed/37307173 http://dx.doi.org/10.1182/bloodadvances.2023009766 Text en © 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Trials and Observations Lee, Dae Hyun Kumar, Abhishek Mohammed, Turab Peres, Lauren C. Alsina, Melissa Bachmeier, Christina Blue, Brandon J. Brayer, Jason Chandrasekhar, Sanjay Grajales Cruz, Ariel De Avila, Gabe Elmariah, Hany Faramand, Rawan Freeman, Ciara Jain, Michael Khadka, Sushmita Khimani, Farhad Liu, Hien Nishihori, Taiga Oswald, Laura B. Castaneda Puglianini, Omar A. Shain, Kenneth H. Smith, Eric Baz, Rachid C. Locke, Frederick L. Oliveira, Guilherme H. Alomar, Mohammed Hansen, Doris K. Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title | Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title_full | Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title_fullStr | Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title_full_unstemmed | Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title_short | Cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
title_sort | cardiac events after standard of care idecabtagene vicleucel for relapsed and refractory multiple myeloma |
topic | Clinical Trials and Observations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424134/ https://www.ncbi.nlm.nih.gov/pubmed/37307173 http://dx.doi.org/10.1182/bloodadvances.2023009766 |
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