ASCO Data Shows New Therapy Keeps Myeloma Patients in Remission for 5+ Years
Multiple myeloma, a complex blood cancer that affects plasma cells, has long posed a formidable challenge in oncology. Over the decades, treatment options have evolved from conventional chemotherapy to proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies. Despite these advances, long-term survival has remained elusive, especially for patients with relapsed or refractory disease. Historically, most therapies have required continuous treatment and often come with severe side effects and diminishing efficacy over time.
This legacy of incremental progress stands in stark contrast to a striking new development: CAR-T cell therapy, and more specifically, cilta-cel (CARVYKTI®), which is reshaping what is possible for multiple myeloma patients.
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This innovation carries even greater urgency and potential impact for Black patients, who face a significantly higher burden of this disease. Although Black individuals make up a smaller percentage of the U.S. population, they are diagnosed with multiple myeloma nearly twice as often as their white counterparts. Despite this elevated risk, access to the latest treatments has historically been limited due to systemic healthcare disparities.
At the forefront of cancer treatment innovation, Dr. Mythili Koneru—a physician-scientist and Chief Medical Officer at Legend Biotech—recently discussed groundbreaking findings in CAR-T cell therapy for multiple myeloma. Presented at the 2025 ASCO (American Society of Clinical Oncology) Annual Meeting, the CARTITUDE-1 study featuring cilta-cel (CARVYKTI®) reveals unprecedented long-term results in a disease traditionally marked by high relapse rates and poor prognosis.
A Breakthrough in Treating Relapsed/Refractory Multiple Myeloma
Multiple myeloma, a blood cancer affecting plasma cells, is notoriously difficult to treat, particularly in later stages. Historically, patients with relapsed or refractory multiple myeloma had a progression-free survival (PFS) of about six months and an overall survival (OS) of approximately one year.
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The CARTITUDE-1 study, however, has delivered what Dr. Koneru calls a “paradigm shift.” Among the key findings:
- A median OS of five years for heavily pretreated patients following a single cilta-cel infusion with no maintenance therapy.
- One-third of patients remained progression-free for five years or more, an outcome previously thought unattainable in this population.
“These are heavily pretreated relapsed/refractory multiple myeloma patients, and to see one-third of them progression-free at five years without follow-up therapy is just remarkable,” Dr. Koneru tells BlackDoctor.org.
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A Functional Cure? Moving Closer Than Ever
While the multiple myeloma field has yet to define a “cure,” the International Myeloma Working Group (IMWG) is expected to release criteria for this later in the year. Until then, experts point to CARTITUDE-1’s results as clear evidence of functional cures, where the disease is controlled long-term without continuous treatment.
“This is more than disease control—it’s long-term hope,” Dr. Koneru adds.
What Drives Long-Term Remission in Cilta-Cel Patients?
The study identified several factors linked to better outcomes:
- Patients with low baseline tumor burden and a higher fraction of naïve T-cells in their CAR-T cell product experienced longer remissions.
- A fitter, less inflammatory immune profile at the time of infusion also correlated with better results.
- Even patients with high-risk cytogenetics and extramedullary plasmacytomas, who usually face poorer outcomes, benefited equally.
Importantly, these response-enhancing characteristics are more common in earlier lines of therapy, suggesting the earlier use of cilta-cel could yield even better results. Bridging therapy to control the disease before infusion plays a crucial role in improving patient outcomes.
Addressing Health Disparities and Expanding Access
Multiple myeloma affects all populations, but it occurs two to three times more often in Black patients than in white patients in the U.S. The promising results of cilta-cel in diverse patient cohorts underscore the need to expand access and make this therapy available across all demographics.
“It’s vital to ensure equitable access to breakthrough therapies like cilta-cel, especially in populations that carry a higher burden of this disease,” Dr. Koneru says.
Convenience, Safety, and Long-Term Management
Cilta-cel’s treatment model also offers unmatched convenience:
- A single infusion, with no need for ongoing maintenance or repeated hospital visits, offers a major quality-of-life advantage over traditional regimens.
- The safety profile is highly manageable, with no new cases of movement or neurocognitive events (MNTs) reported in the study.
- A very small number of patients (1–2%) experienced MNTs in real-world settings, but effective mitigation strategies are already in place.
- Two cases of second primary malignancies—solid tumors—were reported in patients with prior extensive treatment histories.
What’s Next: Bringing CAR-T Earlier in the Treatment Journey
Encouraged by these late-line results, Dr. Koneru and her team are pushing forward:
- New trials are underway to test cilta-cel in frontline settings, including for transplant-ineligible newly diagnosed patients.
- The goal: offer potentially life-saving treatment earlier, when patients’ immune systems are stronger and more responsive.
“Every line of therapy risks losing patients to attrition. Bringing cilta-cel earlier in their journey could dramatically improve survival and quality of life,” Dr. Koneru adds.
A New Era in Myeloma Treatment
Dr. Koneru believes the CARTITUDE-1 study represents a pivotal moment in cancer care. The possibility of remaining cancer-free for five years or longer after a one-time treatment is not just revolutionary—it’s redefining the future of multiple myeloma management.
“To give patients the chance to live without continuous therapy… that’s transformative,” she concludes.
