45 percent reduction in risk of death achieved with CARVYKTI® after three-year follow-up in landmark CARTITUDE-4 study
Data featured in a late-breaking oral presentation at the 2024 International Myeloma Society Annual Meeting
RIO DE JANEIRO, Brazil I September 27, 2024 I Johnson & Johnson (NYSE:JNJ) announced today long-term results from the Phase 3 CARTITUDE-4 study that show a single infusion of CARVYKTI® (ciltacabtagene autoleucel) significantly extended overall survival (OS) in patients with relapsed or lenalidomide-refractory multiple myeloma who have received at least one prior line of therapy, including a proteasome inhibitor (PI), reducing the risk of death by 45 percent versus standard therapies of pomalidomide, bortezomib and dexamethasone (PVd) or daratumumab, pomalidomide and dexamethasone (DPd).1 With these data, CARVYKTI® is now the first and only cell therapy to improve OS versus standard therapies for patients with lenalidomide-refractory multiple myeloma as early as second line.1 Findings were featured as a late-breaking oral presentation at the 2024 International Myeloma Society (IMS) Annual Meeting (Abstract #OA-65).1
“The three-year follow-up data from the Phase 3 CARTITUDE-4 study show a statistically significant and clinically meaningful improvement in overall survival and quality-of-life measures with CARVYKTI versus standard therapies—meaningful results that have the potential to transform the multiple myeloma treatment landscape,” said Binod Dhakal, M.D., M.S., Associate Professor of Medicine at the Medical College of Wisconsin, Division of Hematology, and study investigator.* “This adds to the growing body of data reinforcing the promise of a single infusion of CARVYKTI, which, in addition to demonstrating a significant overall survival benefit, also offers patients the opportunity of a period free from multiple myeloma treatment as early as second line.”
The Phase 3 CARTITUDE-4 study evaluated CARVYKTI® compared to standard therapies of PVd or DPd for the treatment of patients with relapsed or lenalidomide-refractory multiple myeloma after one prior line of therapy.1 Patients who received one to three prior lines of therapy, including a PI and immunomodulatory agent (IMiD), and were lenalidomide-refractory were randomized (CARVYKTI® [cilta-cel], n=208, standard therapies, n=211).1 At median follow-up of almost three years (34 months), median OS for patients treated with both CARVYKTI® or standard therapies was not reached (NR) (95 percent Confidence Interval [CI], not estimable (NE) – NE) and (95 percent CI, 37.75 months – NE) (Hazard Ratio [HR], 0.55; 95 percent CI, 0.39-0.79; P=0.0009).1 At 30-month follow-up, OS rates were 76 percent for patients on the CARVYKTI® arm and 64 percent for patients on the standard therapies arm.1 These data show CARVYKTI® significantly extended OS for patients compared to standard therapies.1
In patients randomized to the CARVYKTI® arm, CARVYKTI® reduced the risk of death by 45 percent compared to standard therapies demonstrating clinically meaningful responses for patients as early as after first relapse.1 Median progression-free survival (PFS) was NR in patients treated with CARVYKTI® (95 percent CI, 34.50 months – NE) and 11.79 months (95 percent CI, 9.66-14.00) in patients treated with standard therapies demonstrating sustained deep and durable responses.1 Patients treated with CARVYKTI® had a 77 percent complete response or better, and 85 percent overall response rate. Patients treated with CARVYKTI® demonstrated a 62 percent minimal residual disease (MRD) negativity (10^-5) and 57 percent MRD-negativity (10^-6) compared to patients treated with standard therapies (18.5 percent, 9 percent), respectively.1 Median duration of response was NR (95 percent CI, NE-NE) in patients treated with CARVYKTI® and 18.7 months (95 percent CI, 12.9-23.7) for patients treated with standard therapies.1 Median time to symptom worsening based on the Multiple Myeloma Symptom and Impact Questionnaire (MySlm-Q) was NR (95 percent CI, NE-NE) with CARVYKTI® and 34.33 months (95 percent CI, 32,20-NE) with patients treated with standard therapies (HR, 0.38; 95 percent CI, 0.24-0.61; P<0.0001).1
The safety profile of cilta-cel versus standard therapies was consistent with previous analysis. In the safety analysis [cilta-cel, n=208, standard therapies, n=208], 97 percent of patients in both arms experienced grade 3/4 treatment-emergent adverse events (TEAEs) with cytopenia being the most common.1 Treatment-emergent infections occurred in 64 percent of patients in the CARVYKTI® arm and 76 percent of patients who received standard therapies with 28 percent and 30 percent being classified as grade 3/4, respectively.1 In the CARVYKTI® arm, there were seven patients with hematologic second primary malignancies, 50 patients died and of those patients, 21 died due to progressive disease.1 One patient treated with standard therapies experienced a hematologic second primary malignancy, 82 patients died and of those patients, 51 died due to progressive disease.1
“CARVYKTI is the first and only cell therapy approved for the treatment of patients with myeloma as early as second line, and now also the first and only cell therapy to improve overall survival and demonstrate improved patient quality-of-life outcomes versus standard therapies for patients with lenalidomide-refractory multiple myeloma,” said Jordan Schecter, M.D., Vice President, Disease Area Leader, Multiple Myeloma, Innovative Medicine, Johnson & Johnson. “At Johnson & Johnson, we remain committed to addressing unmet need through the development of innovative treatments for patients and healthcare providers, and we look forward to submitting these results to local health authorities worldwide.”
The U.S. FDA and European Commission approved CARVYKTI® for the treatment of adult patients with relapsed or refractory multiple myeloma who have received a least one prior line of therapy including a PI, IMiD, and are refractory to lenalidomide earlier this year. Globally, we have now launched CARVYKTI® in 5 countries and treated more than 3,500 patients.
About CARTITUDE-4
CARTITUDE-4 (NCT04181827) is the first randomized Phase 3 study evaluating the efficacy and safety of CARVYKTI®. The study compares CARVYKTI® with standard of care treatments PVd or DPd in adult patients with relapsed and lenalidomide-refractory multiple myeloma who received one to three prior lines of therapy. The primary endpoint of the study is progression-free survival (PFS); safety, OS, minimal residual disease negative rate and overall response rate are secondary endpoints.
About CARVYKTI® (ciltacabtagene autoleucel; cilta-cel)
CARVYKTI® (cilta-cel) received U.S. Food and Drug Administration approval in February 2022 for the treatment of adults with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. In April 2024, CARVYKTI® was approved in the U.S. for treatment of adult patients with relapsed or refractory multiple myeloma who have received at least one prior line of therapy including a proteasome inhibitor, an immunomodulatory agent, and who are refractory to lenalidomide, following a unanimous (11 to 0) FDA Oncologic Drugs Advisory Committee (ODAC) recommendation in support of this new indication. In April 2024, the European Medicines Agency (EMA) approved a Type II variation for CARVYKTI® for the treatment of adults with relapsed and refractory multiple myeloma who have received at least one prior therapy, including an immunomodulatory agent and a proteasome inhibitor, have demonstrated disease progression on the last therapy, and are refractory to lenalidomide. In September 2022, Japan’s Ministry of Health, Labour and Welfare (MHLW) approved CARVYKTI® for the treatment of adults with relapsed or refractory multiple myeloma in patients that have no history of CAR-positive T cell infusion therapy targeting BCMA and who have received three or more lines of therapies, including an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 monoclonal antibody, and in whom multiple myeloma has not responded to or has relapsed following the most recent therapy.
CARVYKTI® is a BCMA-directed, genetically modified autologous T-cell immunotherapy, which involves reprogramming a patient’s own T-cells with a transgene encoding chimeric antigen receptor (CAR) that directs the CAR-positive T cells to eliminate cells that express BCMA. BCMA is primarily expressed on the surface of malignant multiple myeloma B-lineage cells, as well as late-stage B cells and plasma cells. The CARVYKTI® CAR protein features two BCMA-targeting single domains designed to confer high avidity against human BCMA. Upon binding to BCMA-expressing cells, the CAR promotes T-cell activation, expansion, and elimination of target cells.
In December 2017, Janssen Biotech, Inc., a Johnson & Johnson company, entered into an exclusive worldwide license and collaboration agreement with Legend Biotech USA, Inc. to develop and commercialize CARVYKTI®.
For more information, visit www.CARVYKTI.com.
About Multiple Myeloma
Multiple myeloma is an incurable blood cancer that affects a type of white blood cell called plasma cells, which are found in the bone marrow.2 In multiple myeloma, these plasma cells proliferate and spread rapidly and replace normal cells in the bone marrow with tumors.3 Multiple myeloma is the third most common blood cancer worldwide and remains an incurable disease.4 In 2024, it was estimated that more than 35,000 people will be diagnosed with multiple myeloma in the U.S. and more than 12,000 people would die from the disease.5 People living with multiple myeloma have a 5-year survival rate of 59.8 percent.6 While some people diagnosed with multiple myeloma initially have no symptoms, most patients are diagnosed due to symptoms that can include bone fracture or pain, low red blood cell counts, tiredness, high calcium levels and kidney problems or infections.7,8
INDICATIONS AND USAGE
CARVYKTI® (ciltacabtagene autoleucel) is a B-cell maturation antigen (BCMA)-directed genetically modified autologous T cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory multiple myeloma, who have received at least 1 prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent, and are refractory to lenalidomide.
Please read full Prescribing Information, including Boxed Warning, for CARVYKTI®.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com/ or at www.innovativemedicine.jnj.com. Follow us at @JanssenUS and @JNJInnovMed. Janssen Research & Development, LLC and Janssen Biotech, Inc., and Janssen Global Services, LLC are Johnson & Johnson companies.
Please read full Prescribing Information, including Boxed Warning, for CARVYKTI®.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com/ or at www.innovativemedicine.jnj.com. Follow us at @JanssenUS and @JNJInnovMed. Janssen Research & Development, LLC and Janssen Biotech, Inc., and Janssen Global Services, LLC are Johnson & Johnson companies.
SOURCE: Johnson & Johnson