So, I attended a great talk today that looked at comparing CAR-T and bispecific antibody therapies in both lymphoma and multiple myeloma, and I'm going to highlight some of the information that they shared for multiple myeloma specifically. So, in this talk, they reviewed the efficacy of both CAR-T and bispecific therapy in multiple myeloma, including the MajesTEC-3 trial, which basically looked at teclistamab and daratumumab in relapsed/refractory multiple myeloma patients, who'd had one to three prior lines of therapy, and this was compared to investigators' choice of either DPd or DVd, so dara-pom-dex or daratumumab-Velcade-dex. And what these results showed was an impressive 3-year progression-free survival of 83%. Also in this talk, they highlighted the significant increase of serious infection with BCMA-directed bispecific antibody therapy vs CAR T-cell therapy in multiple myeloma patients, and specifically, bispecific antibodies that target BCMA are associated with increased rates of overall infections. And this is likely due to the fact that BCMA is not only expressed on the malignant plasma cell, but it's also expressed on normal plasma cells and mature B cells. So that really highlights the importance of proper infection prophylaxis, IVIG prophylaxis in these patients, and then appropriate infection management as well.
They also highlighted the differences between CAR-T and bispecific antibody therapy. Some of the major differences included the fact that bispecific antibodies are off the shelf, so they're more widely available to patients, whereas CAR T is limited to specialized centers. CAR T does require intensive caregiver support, whereas bispecific antibody therapy requires minimal-to-moderate support, depending on whether they're giving it outpatient or inpatient. Bispecific antibodies can be given to a wider range of patients, including patients with a poor performance status, whereas CAR-T patients, generally, we should be giving it to patients with a good performance status, who have limited comorbidities.
But one thing they highlighted, that CAR T definitely wins in terms of quality of life. So, it's a single infusion. Also, of course, these patients need apheresis and lymphodepleting chemotherapy, but for right now, bispecific antibody therapy is given for multiple cycles. And also we know from the long-term data with CARTITUDE-1 that CAR T-cell therapy has the potential to cure patients or provide a long-term remission. And with bispecific antibodies, it's too early to assess long-term outcomes, but we're seeing really amazing efficacy, especially when these therapies are given in earlier lines. They also highlighted toxicity management, so they talked about CRS and ICANS, how to identify both, also immune effector cell-associated hematotoxicity, HLH, how APPs can, again, best mitigate, manage these toxicities. And yeah, so just a wonderful talk to help us as APPs to, when we talk to our patients, know how to discuss the differences between bispecific antibody therapy and CAR T, and also so that we can more effectively mitigate and manage these toxicities.
Now, I saw a lot of wonderful posters today, but there are a couple that caught my eye. And so, I want to highlight the first one, and the title was, Optimizing Hematopoietic Stem Cell Arrivals: An APP Perspective. The authors of this poster aim to evaluate contributing factors to transplant delays and conversion failures from the hematology oncology service to the bone marrow transplant service that would inform the development of workflow improvements to improve coordination of care between these two services. So, what they did is they conducted a 6-month review, they implemented a QR code and survey, and they created this workflow to shadow and have a multidisciplinary case review. And by doing this, they were able to identify contributing factors to transplant delay and conversion factors. They found that disease progression or relapse was the most common barrier to conversion, and that comorbidities, health maintenance, and psychosocial barriers were the most common reasons for transplant delay.
This poster really highlighted the critical role of APPs and care transitions, and their work helped to inform the development of targeted process improvements such as standardized documentation, and also helped to improve the communication between the hematology, oncology, and the bone marrow transplant teams. This is really important because this highlights the importance of APPs and playing the role of improving communication between different services, and the role that they can play in helping to help patients have timely access to transplant.
The next poster that I wanted to discuss was looking at daratumumab, Velcade, Revlimid, and dexamethasone in patients with newly diagnosed multiple myeloma, and it was the final analysis of transplant-ineligible patients in the phase three CEPHEUS study. So, the phase three CEPHEUS trial established daratumumab, Velcade, Revlimid, and dexamethasone as a new standard of care in transplant-ineligible and transplant-deferred newly diagnosed multiple myeloma, with higher rates of overall MRD negativity, sustained MRD negativity, and improved progression-free survival.
And so, what this poster highlighted was that after a median follow-up of over 6 years, and this was 76 months, the final analysis of the CEPHEUS trial basically demonstrated that daratumumab, Velcade, Revlimid, and dex continue to show superior efficacy over Velcade, Revlimid, and dex across key endpoints in transplant-ineligible multiple myeloma. And also it showed that daratumumab, Velcade, Revlimid, and dex in a post-hoc analysis helped improve depth and duration of response with higher rates of overall MRD negativity and sustained MRD negativity. The poster also highlighted that their risk of disease progression or death was 45% lower for daratumumab, Velcade, Revlimid, and dex, vs Velcade, Revlimid, and dex. Also, when you looked at overall survival data that favored daratumumab, Velcade, Revlimid, and dex, especially when censoring for death due to COVID-19.
Another really important finding is that there's no additional safety concerns that were identified in this older, frailer, transplant-ineligible group, and the median age was 72 years old. So, this is really important for us as APPs to communicate important long-term data like this. It's so important for our transplant-ineligible patients.
