To evaluate the overall survival benefit of ciltacabtagene autoleucel (cilta-cel) in lenalidomide-refractory multiple myeloma.
Key Findings:
Cilta-cel shows a significant overall survival benefit compared to standard care.
High rates of minimal residual disease negativity (62% at 10-5) were observed.
Interpretation:
Limitations:
The control arm may not reflect current treatment standards, potentially overestimating cilta-cel's benefit.
The trial did not standardize bridging regimens, creating uncertainty about their impact on outcomes.
Ethical concerns arise from the no-crossover design, limiting access to cilta-cel for control-arm patients.
Conclusion:
CARTITUDE-4 highlights the potential of cilta-cel to prolong survival in earlier treatment settings, but translating these findings into practice requires addressing significant barriers.
