Dr. Peter Voorhees on T-Cell Fitness and the Potential of Cilta-Cel in Earlier Lines of Therapy

Peter Voorhees, MD, of the Atrium Health Levine Cancer Institute, discussed how T-cell biomarkers correlated with progression-free survival in the CARTITUDE-1 trial of ciltacabtagene autoleucel (cilta-cel) in relapsed or refractory multiple myeloma and what these findings suggest in terms of cilta-cel sequencing.

“We found that the ratio of T cells to neutrophils at the time of leukapheresis was associated with better outcomes,” said Dr. Voorhees. He also explained that a higher number of chimeric antigen receptor (CAR)–positive naive T cells before infusion was associated with long-term remissions and that a high proportion of T cells with central memory phenotype after infusion at the time of peak expansion was associated with longer-term disease control.

“We think that using cilta-cel earlier in the course of therapy, when the patients are less heavily pretreated, will lead to a higher proportion of patients with fit T-cell products to use,” Dr. Voorhees explained. “We also think that using cilta-cel earlier in the treatment continuum affords us the ability to use therapeutics to control the disease before and after leukapheresis as the CAR T-cells are being manufactured, thereby optimizing that effector-to-target ratio and potentially leading to even better outcomes in earlier relapse disease and in potentially newly diagnosed disease as well.”