https://orcid.org/0000-0002-5178-5827
![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
Objective: 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.
Transparency
Declaration of funding
This work was supported by Janssen Pharmaceuticals and Legend Biotech.
Declaration of financial/other relationships
AH, BH, MB, ER, and IAS are employed by EVERSANA, Canada, which was contracted by Janssen to work on this project. PH served in a consulting role for Celgene-BMS, Takeda, GSK, Amgen and Karyopharm, received honoraria from Celgene-BMS, Janssen, Takeda, Amgen, Sanofi, Oncopeptides and Adaptive Biotech, holds membership on an entity's Board of Directors or advisory committees for Celgene-BMS, Janssen, Takeda, GSK, Amgen, Sanofi, Oncopeptides, Adaptive Biotech and Millenium, received research funding from Celgene-BMS, Janssen, Takeda, GSK, Amgen, Sanofi and Millenium, and served on speakers bureaus for Celgene-BMS, Janssen, Takeda, GSK, Amgen, Sanofi, Oncopeptides and Adaptive Biotech. PH also discloses other conflicts of interest with Celgene-BMS, Janssen, Takeda, GSK and Amgen.
JGB served in a consulting role for Bluebird bio, Bristol-Myers Squibb, Celgene, CRISPR Therapeutics, Janssen, KitePharma, Legend Biotech, SecuraBio and Takeda, and received research funding from Abbvie, Acetylon, Amgen, Celularity, CRISPR Therapeutics, EMD Sorono, Genentech, GSK, Ichnos Sciences, Incyte, Lilly, Novartis, Poseida, Sanofi and Teva.
VDS and CZ have no conflicts of interest to disclose. FG served in a consulting role for Sanofi, received honoraria from Amgen, Celgene, Janssen, Takeda, BMS, AbbVie, GlaxoSmithKline and Sanofi, and holds membership on an entity’s Board of Directors or advisory committees for Amgen, Celgene, Janssen, Takeda, AbbVie, GlaxoSmithKline, Roche, Adaptive Biotechnologies, Oncopeptides and Bluebird Bio. SK served in a consulting role for BMS, Abbvie, Amgen, Takeda, Beigene, Oncopeptides, Antengene, Janssen, KITE, Astra-Zeneca, Roche-Genentech and Bluebird Bio, received research funding from BMS, Abbvie, Amgen, Takeda, Tenebio, Carsgen, Janssen, KITE, Merck, Astra-Zeneca, Novartis, and Roche-Genentech, and received honoraria from Antengene. TM served in a consulting role for GlaxoSmithKline and Ocopeptides, and received research funding from Janssen, Amgen and Sanofi. MVM received honoraria from and holds membership on an entity's Board of Directors or advisory committees for Janssen, Celgene-Bristol Myers Squibb, Takeda, Amgen, Adaptive Biotechnologies, Sanofi, Pfizer, Regeneron, Roche, Sea-Gen and Oncopeptides. PM received honoraria from Abbvie, Amgen, Janssen, Sanofi, Celgene BMS and Oncopeptides.
SZU served in a consulting role for AbbVie, Amgen, Array BioPharma, Celgene/BMS, GSK, EdoPharma, Janssen, Janssen Oncology, Sanofi, Merck, Pharmacyclics, Seattle Genetics, Skyline DX, and Takeda, served on speakers bureaus for Amgen, Celgene, Janssen, Sanofi, and Takeda, and received research funding from Amgen, Array BioPharma, Celgene/BMS, GSK, Janssen, Janssen Oncology, Merck, Pharmacyclics, Seattle Genetics, Skyline DX, Takeda. KW received honoraria from and served in a consulting role for Adaptive Biotechnologies, Karyopharm, and Takeda, received honoraria from Bristol Myers Squibb, Celgene, Amgen, GSK, Janssen, Oncopeptides, Roche and Sanofi, received research funding from Celgene, Amgen, Janssen, and Sanofi, and holds membership on an entity’s Board of Directors or advisory committees for Adaptive Biotechnologies, Bristol Myers Squibb, Celgene, Amgen, GSK, Janssen, Karyopharm, Oncopeptides, Takeda, and Sanofi. CCJ is an employee of Janssen and served in a consulting role for the Memorial Sloan Kettering Cancer Center. YO, JMS, MV, JD, and SV are employees of Janssen and have restricted stock units and/or stock options. AG, TN, and SL are employees of Legend Biotech USA. SL is a current equity holder in Legend Biotech USA. LP is an employee of Legend Biotech. LJC served in a consulting role for Amgen, Janssen, BMS, Karyopharm, Pfizer, and Sanofi, has received honoraria and research funding from Amgen, Janssen, and BMS, has received honoraria from Karyopharm, Pfizer, and Sanofi, and served on speakers bureaus for Amgen and Sanofi. YL served in a consulting role for Kite, a Gilead Company, Janssen, Novartis, Celgene, Bluebird Bio, Juno, Legend, Sorrento, Gamida Cell, and Vineti, and has received research funding from Kite, a Gilead Company, Janssen, Celgene, Bluebird Bio, Merck, and Takeda. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
All authors were responsible for study conception and design. BH, MB, ER, AH and IAS were responsible for acquisition, analysis, and the initial draft of the manuscript. All authors were responsible for interpretation of data and revising it critically.
Acknowledgements
The CARTITUDE-1 study and these analyses were funded by Janssen Research & Development, LLC, and Legend Biotech, Inc. Medical writing support was provided by EVERSANA and funded by Janssen Global Services, LLC.