BCMA/CD19 dual-targeting CAR T-cell therapy in older patients with newly diagnosed multiple myeloma: a phase 1 study.

abstractGC012F, now renamed AZD0120, is an autologous B-cell maturation antigen and CD19 dual-targeting chimeric antigen receptor (CAR) T-cell product manufactured on the FasTCAR platform. CAR T-cell therapy has not been routinely studied in older patients with newly diagnosed multiple myeloma (NDMM), so we assessed AZD0120 as frontline treatment for patients with MM aged ≥70 years. In this single arm phase I study, patients with NDMM aged ≥70 years received 2 cycles of VRD (bortezomib/lenalidomide/dexamethasone) induction therapy followed by AZD0120 infusion at the dose of 1.5 × 105 or 3 × 105 cells per kg. Eight patients received AZD0120, with 4 frail and 4 nonfrai according to the Intergroupe Francophone du Myclome Simplified Frailty Score criteria. At a median follow-up of 9.8 months after infusion, hematologic toxicities were the most common grade ≥3 treatment-emergent adverse events, including lymphopenia (25%), leukopenia (50%), and neutropenia (75%). Four (50%) patients had cytokine release syndrome, all grade 1. No immune effector cell-associated neurotoxicity syndrome was observed. All patients achieved a stringent complete response, and all patients achieved minimal residual discase (MRD) negativity by Euroflow (10-6) at 1 month, with MRD negativity rates of 100% among evaluable patients at month 6 (n = 7) and month 12 (n = 2). Two frail patients with Eastern Cooperative Oncology Group (ECOG) performance status score of 2 improved to score 1 after infusion. AZD0120 CAR T-cell therapy shows promising preliminary efficacy and a manageable safety profile for older patients with NDMM. This trial was registered at www.clinicaltrials.gov as NCT05840107.