CARVYKTI® (ciltacabtagene autoleucel) HCP

Depth of Response

CARTITUDE-4 Study^1,2

CARTITUDE-4 is a randomized, open label, multicenter controlled study in adult patients with relapsed and lenalidomide-refractory multiple myeloma, who previously received at least 1 prior line of therapy including a proteasome inhibitor and an immunomodulatory agent. A total of 419 patients were randomized 1:1 to receive either a sequence of apheresis, bridging therapy, lymphodepletion, and CARVYKTI® (n=208) or standard therapy which included daratumumab, pomalidomide, and dexamethasone (DPd) or bortezomib, pomalidomide, and dexamethasone (PVd) selected by physician prior to randomization based on patient’s prior antimyeloma therapy (n=211).

CARVYKTI® (ciltacabtagene autoleucel) CARTITUDE-4 study design

Primary Endpoint:
PFS (Intent-to-Treat)^†

Select Secondary Endpoints^||:
CR or better, ORR (sCR + CR + VGPR + PR)

CAR+=chimeric antigen receptor-positive; CR=complete response; DOR=duration of response; IMWG=International Myeloma Working Group;

IRC=Independent Review Committee; IV=intravenous infusion; LoT=line(s) of therapy; ORR=overall response rate; PFS=progression-free survival;

PR=partial response; sCR=stringent complete response; VGPR=very good partial response.

*Randomization was stratified by physician’s choice of treatment (DPd vs PVd), ISS (I vs II vs III) and number of prior lines of therapy (1 vs 2 or 3).

^†Per the IMWG consensus, assessed by IRC.

^‡80.8% of patients received 1-2 cycles of standard therapy. Maximum received was 6 cycles in 1 patient.

^§The remaining 32 patients discontinued trial participation before receiving CARVYKTI®, predominantly because of disease
progression during bridging therapy or lymphodepletion. Of these patients, 20 received CARVYKTI® as a subsequent therapy.¹

^||Secondary outcomes were sequentially tested at each prespecified significance level, including (in order) rates of CR or better, ORR.²

ELIGIBILITY CRITERIA^1,2

Key Inclusion Criteria

Adult patients with RRMM
Received 1-3 prior LoT including a PI
and an immunomodulatory agent
Refractory to lenalidomide
ECOG PS 0-1

Key Exclusion Criteria

Prior CAR-T or BCMA-targeting therapy
Known active or prior history of central nervous system involvement
Exhibit clinical signs of meningeal involvement of multiple myeloma
History of Parkinson’s disease or other neurodegenerative disorder

BCMA=B-cell maturation antigen; CAR-T=chimeric antigen receptor-T cell; ECOG PS=Eastern Cooperative Oncology Group performance status; LoT=line(s) of therapy; PI=proteasome inhibitor; RRMM=relapsed or refractory multiple myeloma.

CARTITUDE-4 STUDY:
BASELINE CHARACTERISTICS (N=419)^1,2

You are now viewing an analysis from the CARTITUDE-4 trial. This information is not included in the current USPI.

CHARACTERISTIC	CARVYKTI^® (N=208)	STANDARD THERAPY (N=211)
Median age, years (range)	61.5 (27-78)	61.0 (35-80)
Male, n (%)	116 (55.8)	124 (58.8)
Race or ethnic group, n (%)^*
Asian	16 (7.7)	20 (9.5)
Black	6 (2.9)	7 (3.3)
White	157 (75.5)	157 (74.4)
Other	1 (0.5)	1 (0.5)
Missing data	28 (13.5)	26 (12.3)
Hispanic or Latino ethnic group, n (%)^*
Hispanic or Latino	18 (8.7)	10 (4.7)
Not Hispanic or Latino	152 (73.1)	165 (78.2)
Missing data	38 (18.3)	36 (17.1)
Geographic region
Europe	128 (61.5)	129 (61.1)
North America	32 (15.4)	32 (15.2)
Asia	27 (13.0)	25 (11.8)
Australia	21 (10.1)	25 (11.8)
ECOG PS score, n (%)^†
0	114 (54.8)	121 (57.3)
1	93 (44.7)	89 (42.2)
2	1 (0.5)	1 (0.5)
ISS stage, n (%)
I	136 (65.4)	132 (62.6)
II	60 (28.8)	65 (30.8)
III	12 (5.8)	14 (6.6)
Median time since diagnosis, years (range)	3.0 (0.3-18.1)	3.4 (0.4-22.1)
Presence of soft-tissue plasmacytomas^‡, n (%)	44 (21.2)	35 (16.6)
Bone marrow plasma cells >60%^§, n/total n (%)	42/206 (20.4)	43/208 (20.7)
Cytogenetic risk, n/total n (%)
Standard risk	69/207 (33.3)	70/210 (33.3)
High Cytogenetic Risk, n/N (%)^§	123/207 (59.4)	132/210 (62.9)
Gain/amp(1q)	89/207 (43.0)	107/210 (51.0)
del(17p)	49/207 (23.7)	43/210 (20.5)
t(4;14)	30/207 (14.5)	30/210 (14.3)
t(14;16)	3/207 (1.4)	7/210 (3.3)
With ≥2 high-risk mutations	43/207 (20.8)	49/210 (23.2)
With del(17p), t(4;14), or t(14;16)	73/207 (35.3)	69/210 (32.9)
Missing data	15/207 (7.2)	8/210 (3.8)
Tumor BCMA expression ≥50%, n (%)	141 (67.8)	138 (65.4)
Prior lines of therapy, n (%)
1	68 (32.7)	68 (32.2)
2	83 (39.9)	87 (41.2)
3	57 (27.4)	56 (26.5)
Prior immunomodulatory agents, n (%)	208 (100.0)	211 (100.0)
Lenalidomide	208 (100.0)	211 (100.0)
Pomalidomide	8 (3.8)	10 (4.7)
Prior anti-CD38 antibody, n (%)	53 (25.5)	55 (26.1)
Daratumumab	51 (24.5)	54 (25.6)
Isatuximab	2 (1.0)	2 (0.9)
Prior proteasome inhibitor, n (%)	208 (100.0)	211 (100.0)
Bortezomib	203 (97.6)	205 (97.2)
Carfilzomib	77 (37.0)	66 (31.3)
Ixazomib	21 (10.1)	21 (10.0)
Triple-class^¶ exposed, n (%)	53 (25.5)	55 (26.1)
Penta-drug^** exposed, n (%)	14 (6.7)	10 (4.7)
Refractory status, n (%)
Lenalidomide	208 (100.0)	211 (100.0)
Bortezomib	55 (26.4)	48 (22.7)
Carfilzomib	51 (24.5)	45 (21.3)
Any anti-CD38 antibody	50 (24.0)	46 (21.8)
Daratumumab	48 (23.1)	45 (21.3)
Ixazomib	15 (7.2)	17 (8.1)
Pomalidomide	8 (3.8)	9 (4.3)
Triple-class^¶	30 (14.4)	33 (15.6)
Penta-drug^**	2 (1.0)	1 (0.5)

amp=amplification; BCMA=B-cell maturation antigen; CD38=cluster of differentiation 38; del=deletion; ECOG PS=Eastern Cooperative Oncology Group performance status; Gain/amp=gain or amplification; ISS=International Staging System; t=translocation; USPI=US Prescribing Information.

^*Race or ethnic group was reported by the patients. Among the patients who were enrolled in the United States, 9 (14.1%) were Black. The designation of “Other” includes American Indian and Alaska Native ethnic groups.

^†Listed is the latest available performance-status score on the Eastern Cooperative Oncology Group (ECOG) scale that was recorded on or before the initiation of apheresis or cycle 1. All the patients met the inclusion criteria of an ECOG performance-status score of 0 or 1 before randomization.

^‡Soft-tissue plasmacytomas include extramedullary and bone-based plasmacytomas with a measurable soft-tissue component.

^§High-risk cytogenetics, presence of t(4:14), (14:16), and 17p13 del, were present in 34% of patients.

^‖In the measurement of bone marrow plasma cells, the maximum value from bone marrow biopsy and bone marrow aspirate was selected if both results were available.

^¶Triple-class therapy includes one proteasome inhibitor, one immunomodulatory agent, and one anti-CD38 monoclonal antibody.

^**Penta-drug therapy includes at least 2 proteasome inhibitors, at least two immunomodulatory agents, and one anti-CD38 monoclonal antibody.

1
2
3
4
Progression–Free Survival (PFS)

Powerful Results

In CARTITUDE-4

CARVYKTI^® SIGNIFICANTLY PROLONGED Progression-Free Survival (PRIMARY ENDPOINT) vs STANDARD THERAPY (DPd OR PVd)^*1

61% (n=208) MRD-5 negativity cilta-cel vs 16% (n=211) MRD-5 negativity SoC (PVd or DPd)

PFS SUBGROUP ANALYSIS

Percentages rounded to nearest whole number.

CI=confidence interval; DOR=duration of response; DPd=daratumumab, pomalidomide, and dexamethasone; HR=hazard ratio; ITT=intent to treat; mPFS=median progression-free survival; MRD=minimal residual disease; ORR=overall response rate; PVd=pomalidomide, bortezomib, and dexamethasone.

^*Median follow-up was 15.9 months in the Intent-to-Treat Analysis Set.

Study Design
1
2
3
4
Depth of Response

Deep responses

In CARTITUDE-4³

85% OVERALL RESPONSE RATE WAS ACHIEVED WITH CARVYKTI^®, AND 81% OF PATIENTS ACHIEVED A DEEP RESPONSE^*1,4

Chart showing CARTITUDE-4 depth of response 85% ORR and 67% ORR

Percentages rounded to nearest whole number.

CI=confidence interval; CR=complete response; DPd=daratumumab, pomalidomide, and dexamethasone; ORR=overall response rate; PR=partial response; PVd=pomalidomide, bortezomib, and dexamethasone; sCR=stringent complete response; VGPR=very good partial response.

^*15.9 months follow-up (Intent-to-Treat Analysis Set).

^†Includes patients who achieved PR or better.

Progression–Free Survival (PFS)
1
2
3
4
Duration of Response

Durable responses

In CARTITUDE-4

Median Duration of Response for CARVYKTI^® Was Not Reached^*1

Cilta-cel (n=208) not reached | SoC (PVd or DPd)* (n=211) 16.6 months

mDOR was not reached in patients who achieved PR or better or in patients who achieved CR or better

CI=confidence interval; CR=complete response; DOR=duration of response; DPd=daratumumab, pomalidomide, and dexamethasone; mDOR=median duration of response; NE=not estimable; PR=partial response; PVd=pomalidomide, bortezomib, and dexamethasone; USPI=US Prescribing Information.

^*15.9 months follow-up (Intent-to-Treat Analysis Set).

^†Estimated mDOR.

Depth of Response
1
2
3
4
Depth of Response

EFFICACY OUTCOMES FROM THE CARTITUDE-4 STUDY

CARTITUDE-4 Study^1,2