Abstract Racial and ethnic minorities have been underrepresented in pivotal trials of idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), limiting the generalizability of findings. This multicenter retrospective study evaluated real-world outcomes in minority patients (MP) versus White patients (WP) treated with cilta-cel or ide-cel across five U.S. centers between May 2022 and April 2024. Among 223 patients, 21% self-identified as racial minorities (39 Black, 2 Asian, 2 Hispanic, 3 other). MPs were younger at infusion (mean age 61.3 vs. 64.8 years; p = 0.012) and more likely to have impaired renal function (CrCl p = 0.011). Other baseline disease characteristics were similar between groups. At 6 months, overall response rate (ORR) was 84% in MPs and 71% in WPs. Median progression-free survival was 16.1 months in MPs and 14.1 months in WPs, while median overall survival was 26.4 vs. 27.9 months, respectively; these differences were not statistically significant. Toxicity profiles were comparable overall; however, MPs experienced significantly higher rates of grade 4 neutropenia (41% vs. 21%; p = 0.01 ). In this real-world cohort, cilta-cel and ide-cel demonstrated similar efficacy and safety in MPs compared to WPs. These results support the use of BCMA-targeted CAR-T therapies across diverse populations and highlight the continued need to improve minority representation in clinical trials to ensure equitable access and outcomes in multiple myeloma care.
Bhutani et al. (Thu,) studied this question.
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