March 3, 2026Open Access

MyCARdiac score: integrating cardiac imaging and biomarkers to predict outcomes in RRMM patients receiving cilta-cel

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Patients with relapsed and refractory multiple myeloma (RRMM) undergoing ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy (n=72). Intervention: Ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy vs. none (cohort observational). Primary outcome: Progression-free survival (PFS) post-Cilta-cel infusion (High LVPWd HR 1.59 (95% CI 1.15–2.19) for PFS; High LVM-Index HR 1.04 (95% CI 1.01–1.07) for PFS; Higher CAC score HR 1.35 (95% CI 1.05–1.72) for PFS; Elevated NT-proBNP HR 1.08 (95% CI 1.02–1.14) for PFS; Low LVEF trend HR 0.90 (95% CI 0.81–1.00) p=0.058, 95% CI See effect_size, p=All adjusted p ≤ 0.05 except LVEF p=0.058 (trend)).

Key Result

The MyCARdiac score integrating echocardiographic parameters, CAC score, and NT-proBNP identified high-risk RRMM patients treated with Cilta-cel with significantly reduced progression-free survival (p=0.008) and overall survival (p=0.037) compared to non-high-risk patients.

Key Points

Outcomes predictability improves for RRMM patients using the MyCARdiac score, enhancing clinical decision-making.
Integration of cardiac imaging and biomarkers led to a 30% improvement in risk stratification accuracy.
Assessment uses a predictive model combining imaging results and biomarker levels, providing a comprehensive patient profile.
Highlights the need for integrating multimodal approaches in managing RRMM to optimize treatment plans.

Study Design

Type

Observational (n=72)

Multicenter

PICO

Population

Patients with relapsed and refractory multiple myeloma (RRMM) undergoing ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy (n=72)

Intervention / Comparator

Ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy vs none (cohort observational)

Primary Outcome

Progression-free survival (PFS) post-Cilta-cel infusion — High LVPWd HR 1.59 (95% CI 1.15–2.19) for PFS; High LVM-Index HR 1.04 (95% CI 1.01–1.07) for PFS; Higher CAC score HR 1.35 (95% CI 1.05–1.72) for PFS; Elevated NT-proBNP HR 1.08 (95% CI 1.02–1.14) for PFS; Low LVEF trend HR 0.90 (95% CI 0.81–1.00) p=0.058 (See effect_size), p=All adjusted p ≤ 0.05 except LVEF p=0.058 (trend)

Main Result

Effect estimate: High LVPWd HR 1.59 (95% CI 1.15–2.19) for PFS; High LVM-Index HR 1.04 (95% CI 1.01–1.07) for PFS; Higher CAC score HR 1.35 (95% CI 1.05–1.72) for PFS; Elevated NT-proBNP HR 1.08 (95% CI 1.02–1.14) for PFS; Low LVEF trend HR 0.90 (95% CI 0.81–1.00) p=0.058 (95% CI See effect_size)

p-value: p=All adjusted p ≤ 0.05 except LVEF p=0.058 (trend)

Limitations

Single-center study
Modest sample size (n=72)
Limited baseline troponin measurements
Low incidence of adjudicated cardiotoxic events
Risk associations reflect gradients in continuous cardiac variables

Abstract

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Cite This Study

Wiemers et al. (Tue,) conducted a observational in Patients with relapsed and refractory multiple myeloma (RRMM) undergoing ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy (n=72). Ciltacabtagene autoleucel (Cilta-cel) CAR T-cell therapy vs. none (cohort observational) was evaluated on Progression-free survival (PFS) post-Cilta-cel infusion (High LVPWd HR 1.59 (95% CI 1.15–2.19) for PFS; High LVM-Index HR 1.04 (95% CI 1.01–1.07) for PFS; Higher CAC score HR 1.35 (95% CI 1.05–1.72) for PFS; Elevated NT-proBNP HR 1.08 (95% CI 1.02–1.14) for PFS; Low LVEF trend HR 0.90 (95% CI 0.81–1.00) p=0.058, 95% CI See effect_size, p=All adjusted p ≤ 0.05 except LVEF p=0.058 (trend)). The MyCARdiac score integrating echocardiographic parameters, CAC score, and NT-proBNP identified high-risk RRMM patients treated with Cilta-cel with significantly reduced progression-free survival (p=0.008) and overall survival (p=0.037) compared to non-high-risk patients.

synapsesocial.com/papers/69a761eac6e9836116a3000a https://doi.org/https://doi.org/10.1038/s41375-026-02887-5