OBJECTIVES: Chimeric antigen receptor T-cell (CAR-T) therapies are the newest approved class of therapy for multiple hematologic malignancies including multiple myeloma (MM). With nearly 2 years real-world experience we sought to examine clinical characteristics of patients who received, were waiting, or did not receive CAR-t therapy for MM.

METHODS: Patients with a MM diagnosis, age ≥18, treated or referred for either idecabtagene vicleucel (Approved 03/2021) or ciltacabtagene autoleucel (approved 02/2022) post-approval were selected from the EVERSANA EMR Database. Patient characteristics and treatment patterns were analyzed. CAR-t administration was confirmed via structured and unstructured data review.

RESULTS: Ninety-nine (99) MM patients had a treatment record or a mention of CAR-T in clinical notes. Of those, 39 received CAR-t while 60 had not. Mean months to CAR-t was 72.9 from diagnosis. Line of therapy (LOT) in which CAR-t was received: 5^th = 4.2%, 6^th = 29.2%, 7^th/8^th = 29.2%, and ≥9^th = 37.5%. Comparing administered to not yet treated mean (SD) age was 61.9 (7.6) vs 63.1(8.5), 41.0% vs 31.7% were female, 35.9% vs 26.7% lived in the northeast and 46.0% vs 32.8% had CCI ≥4, respectively. Prior to receiving the CAR-T 25.6% vs 35.0% had inpatient visit, and 12.8% vs 18.3% had an ER visit, respectively. Pre-CAR-t most common regimens by LOT were: LOT1 = velcade-revlimid-dexamethasone (42%); LOT2 = velcade-cyclophosphamide-dexamethasone (15%). In LOT3 35% of patients received pomalidomide, 35% carfilzomib and 19% daratumumab. Of the 60 not yet treated, 60% had discussed CAR-t (but not referred) while 34.6% were planning, recommended, referred, registered or waiting for administration.

CONCLUSIONS: This is the first published data to describe real-world, U.S. patients with MM treated or referred for CAR-t therapy. Given the demographic and clinical heterogeneity in the real-world cohorts further exploration of outcomes is required given the highly controlled nature of the pivotal trials.