- Luciano J Costa, Parameswaran Hari, Jesus G Berdeja, Valerio De Stefano, Francesca Gay, Becky Hooper, Meaghan Bartlett, Anja Haltner, Emily Rosta, Shaji Kumar, Thomas Martin, Maria-Victoria Mateos, Philippe Moreau, Saad Z Usmani, Yunsi Olyslager, Jordan M Schecter, Tito Roccia, Ashraf Garrett, Sam Lee, Tonia Nesheiwat, Lida Pacaud, Changwei Zhou, Imtiaz A Samjoo, Yi Lin, Joris Diels, Satish Valluri, and Katja Weisel.
- University of Alabama at Birmingham, Birmingham, AL, USA.
- Curr Med Res Opin. 2022 Oct 1; 38 (10): 175917671759-1767.
AbstractObjective: In the absence of head-to-head trials, indirect treatment comparisons (ITCs) between ciltacabtagene autoleucel (cilta-cel; in CARTITUDE-1) and treatments used in real-world clinical practice (physician's choice of treatment [PCT]), were previously conducted. We conducted multiple meta-analyses using available ITC data to consolidate the effectiveness of cilta-cel versus PCT for patients with triple-class exposed relapsed or refractory multiple myeloma (RRMM).Methods: Five ITCs were assessed for similarity to ensure robust comparisons using meta-analysis. Effectiveness outcomes were overall survival (OS), progression-free survival (PFS), time to next treatment (TTNT), and overall response rate (ORR). A robust variance estimator was used to account for the use of CARTITUDE-1 in each pairwise ITC. Analyses were conducted in both treated and enrolled populations of CARTITUDE-1.Results: Four ITCs were combined for evaluation of OS. Results were statistically significantly in favor of cilta-cel versus PCT in treated patients (hazard ratio [HR]: 0.24, 95% confidence interval [CI]: 0.22-0.26). Three ITCs were combined for evaluation of PFS and TTNT. Cilta-cel reduced the risk of progression and receiving a subsequent treatment by 80% (HR: 0.20 [95% CI: 0.06, 0.70]) and 83% (HR: 0.17 [95% CI: 0.12, 0.26]), respectively. Three ITCs were combined for evaluation of ORR. Cilta-cel increased the odds of achieving an overall response by 86-times versus PCT in treated patients. Findings were consistent in the enrolled populations and across sensitivity analyses.Conclusions: Evaluating multiple indirect comparisons, cilta-cel demonstrated a significantly superior advantage over PCT, highlighting its effectiveness as a therapy in patients with triple-class exposed RRMM.
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