Ankit Kansagra, Medical Oncologist and Associate Vice President of Oncology Integration, shared Breno Moreno de Gusmão’s, Vice Clinical Director at BP Mirante, BP – A Beneficência Portuguesa de São Paulo, post on X, adding:
“How much of our CAR-T response assessment is looking at one marrow sample and hoping it speaks for the whole skeleton?
The Nantes group (Jamet, Moreau, Touzeau and colleagues) in HemaSphere: 73 triple-class RRMM pts enrolled prospectively at one center, with simultaneous whole-body FDG-PET/MRI before ide-cel (after bridging) and again for response.
- Before infusion, 64 of 72 imaged pts (89%) still had active disease. Bridging rarely gets anyone to CAR-T clean
- A diffuse marrow pattern predicted shorter PFS on either modality, HR 2.65 on PET and 2.69 on MRI
- After ide-cel, DW-MRI found residual disease in 14% and PET in 11%. Read together, 20% (13 of 66)
- Residual disease on DW-MRI carried an HR of 4.11 for PFS, and pts positive on both scans formed a very high-risk group
Marrow MRD samples one spot.
After BCMA CAR-T we see relapses in places a hip aspirate never reaches, and the combined read caught more pts than either scan alone.
Those are the pts we’d otherwise call a CR and send home with a 3-month follow-up․
Getting this into routine care is not easy.
Simultaneous PET/MRI is a scanner very few CAR-T centers have, MY-RADS reads need trained radiologsts, and payers already push back on one scan, let alone two.
Love the advance and technology.
Nice work from Nantes team.”
Quoting Breno Moreno de Gusmão’s post:
“Ide-cel in triple-class RRMM (n=73): baseline WB FDG-PET/MRI showed active disease in 89%.
Diffuse marrow involvement predicted shorter PFS (HR ~2.7), and residual disease on DW-MRI post-infusion had HR 4.11. Imaging adds to MRD.”
Title: Prognostic value of simultaneous (18F) FDG-PET/MRI in refractory multiple myeloma treated with anti-BCMA CAR T
Authors: Bastien Jamet, Huajun Sun, Chloé François, Hatem Necib, Aurélien Monnet, Éric Frampas, Nicolas Blin, Nicoletta Libera Lilli, Caroline Bodet-Milin, Philippe Moreau, Françoise Kraeber-Bodere, Cyrille Touzeau
You can also read: ISASOCUT: Subcutaneous Isatuximab With On-Body Injector in Newly Diagnosed Multiple Myeloma
