Yan Leyfman, Medical Oncologist, Co-Founder and Executive Director of MedNews Week, shared a post on LinkedIn:
“Does treatment sequence matter in relapsed/refractory multiple myeloma?
A simulation analysis evaluating treatment strategies in 4L+ RRMM suggests that CAR T-cell therapy followed by a bispecific antibody (BsAb) may provide substantially better long-term outcomes than the reverse sequence.
Key findings from the 10-year Markov model:
- Median PFS: 46.4 vs 16.8 months (HR 0.36).
- Median OS: 61.5 vs 32.0 months (HR 0.52).
- 64% reduction in risk of progression or death.
- 48% reduction in risk of death.
- Estimated cost savings of > $430,000 per patient over 10 years.
These findings align with emerging clinical observations suggesting that outcomes with CAR T may be diminished after prior exposure to bispecific antibodies, highlighting the importance of preserving access to cellular therapy earlier in the treatment course.
Importantly, this was a simulation model based on clinical trial and real-world data rather than a prospective randomized study. Nevertheless, the results contribute to the ongoing discussion regarding optimal sequencing of CAR T-cell therapies and bispecific antibodies as both modalities become increasingly integrated into the management of relapsed/refractory multiple myeloma.
As the treatment landscape continues to evolve, determining the right therapy-and the right order-may be just as important as selecting the therapy itself.”
Title: Impact of Treatment Sequencing with CAR T-cell Therapies and Bispecific Antibodies on Long-term Survival in 4L+ RRMM in the United States: A Simulation Model
Authors: Jodi Lipof, Brian Bloudek, Avik Ray, Jie Ting, Ken Hasegawa, Cynthia Gong, Troy Williams, Scott Ramsey, Ajai Chari
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