Bristol Myers Squibb Highlights Progress of Cell Therapy Portfolio at ASH 2024 with Long-Term Survival Data and Results from Expanding Pipeline
Bristol Myers Squibb (BMY) presented results from 18 studies at ASH 2024, showcasing progress in cell therapy across blood cancers and autoimmune diseases. Key highlights include long-term survival data for Breyanzi in lymphoma treatments, showing 38% 5-year overall survival rate and favorable safety profiles.
The company revealed first survival data for arlocabtagene autoleucel in multiple myeloma, demonstrating 87% overall response rate. New analysis showed 96.8% manufacturing success rate for Abecma globally. Additionally, updated results for CD19 NEX-T showed promise in treating severe autoimmune conditions, including lupus.
Bristol Myers Squibb (BMY) ha presentato i risultati di 18 studi all'ASH 2024, evidenziando i progressi nella terapia cellulare per i tumori ematologici e le malattie autoimmuni. I punti salienti includono i dati di sopravvivenza a lungo termine per Breyanzi nei trattamenti per il linfoma, che mostrano un tasso di sopravvivenza globale del 38% a 5 anni e profili di sicurezza favorevoli.
L'azienda ha rivelato i primi dati di sopravvivenza per arlocabtagene autoleucel nel mieloma multiplo, dimostrando un tasso di risposta globale dell'87%. Una nuova analisi ha mostrato un tasso di successo nella produzione del 96,8% per Abecma a livello globale. Inoltre, i risultati aggiornati per CD19 NEX-T hanno mostrato promesse nel trattamento di condizioni autoimmuni severe, tra cui il lupus.
Bristol Myers Squibb (BMY) presentó resultados de 18 estudios en ASH 2024, demostrando avances en la terapia celular para el cáncer de sangre y enfermedades autoinmunes. Los aspectos más destacados incluyen datos de supervivencia a largo plazo para Breyanzi en tratamientos de linfoma, mostrando una tasa de supervivencia global del 38% a 5 años y perfiles de seguridad favorables.
La empresa reveló los primeros datos de supervivencia para arlocabtagene autoleucel en mieloma múltiple, mostrando una tasa de respuesta global del 87%. Un nuevo análisis mostró una tasa de éxito de fabricación del 96,8% para Abecma a nivel mundial. Además, los resultados actualizados para CD19 NEX-T mostraron promesas en el tratamiento de condiciones autoinmunes severas, incluyendo lupus.
브리스톨 마이어스 스퀴브(BMY)는 ASH 2024에서 18개의 연구 결과를 발표하여 혈액암 및 자가면역 질환에 대한 세포 치료의 진전을 보여주었습니다. 주요 내용으로는 브레이얀지의 림프종 치료에 대한 장기 생존 데이터가 포함되어 있으며, 5년 전체 생존율이 38%이고 안전성 프로필이 우수합니다.
회사는 다발성 골수종에 대한 알로카브타겐 오톨류셀의 첫 생존 데이터를 발표하여 87%의 전체 반응률을 입증했습니다. 새로운 분석에서는 아베크마의 전 세계 제조 성공률이 96.8%에 달한다고 밝혔습니다. 또한, CD19 NEX-T의 업데이트된 결과는 루푸스를 포함한 중증 자가면역 질환 치료에 대한 희망을 보여주었습니다.
Bristol Myers Squibb (BMY) a présenté les résultats de 18 études lors de l'ASH 2024, mettant en lumière les avancées de la thérapie cellulaire dans le traitement des cancers du sang et des maladies auto-immunes. Parmi les points forts, on trouve des données de survie à long terme pour Breyanzi dans les traitements du lymphome, affichant un taux de survie global à 5 ans de 38% et des profils de sécurité favorables.
L'entreprise a également révélé les premières données de survie pour arlocabtagene autoleucel dans le myélome multiple, démontrant un taux de réponse global de 87%. Une nouvelle analyse a montré un taux de réussite de fabrication de 96,8% pour Abecma à l'échelle mondiale. De plus, les résultats mis à jour pour CD19 NEX-T ont montré des promesses dans le traitement des maladies auto-immunes graves, y compris le lupus.
Bristol Myers Squibb (BMY) stellte auf der ASH 2024 Ergebnisse aus 18 Studien vor, die Fortschritte in der Zelltherapie bei Blutkrebs und Autoimmunerkrankungen zeigen. Zu den wichtigsten Highlights gehören Langzeitüberlebensdaten für Breyanzi in der Lymphombehandlung, die eine 5-Jahres-Gesamtüberlebensrate von 38% und günstige Sicherheitsprofile zeigen.
Das Unternehmen gab die ersten Überlebensdaten für arlocabtagene autoleucel bei multiplem Myelom bekannt, die eine Gesamtansprechrate von 87% zeigen. Eine neue Analyse ergab eine globale Erfolgsquote von 96,8% bei der Herstellung von Abecma. Zudem zeigen aktualisierte Ergebnisse für CD19 NEX-T vielversprechende Ansätze zur Behandlung schwerer Autoimmunerkrankungen, einschließlich Lupus.
- Breyanzi showed 38% 5-year overall survival rate in LBCL patients
- Arlocabtagene autoleucel achieved 87% overall response rate in multiple myeloma
- Abecma demonstrated 96.8% manufacturing success rate globally
- CD19 NEX-T showed significant disease improvement in lupus patients
- None.
Insights
The extensive data presented at ASH 2024 demonstrates significant progress in BMY's cell therapy portfolio, particularly for Breyanzi and emerging pipeline candidates. The 5-year survival data for Breyanzi in LBCL shows impressive durability with
The first survival data for arlo-cel in multiple myeloma is particularly noteworthy, with an
The CD19 NEX-T program's expansion into autoimmune diseases represents a potential breakthrough, showing promising early efficacy in lupus and other conditions while maintaining a manageable safety profile. This could open up entirely new markets beyond oncology.
From a commercial perspective, BMY's cell therapy portfolio expansion is strategically significant. The robust manufacturing success rate of
The breadth of positive data across multiple indications suggests strong revenue growth potential. Breyanzi's expanded utility in second-line LBCL and other lymphomas, combined with arlo-cel's potential in multiple myeloma and NEX-T's possibility in autoimmune diseases, could help offset BMY's upcoming patent cliffs. The real-world evidence supporting Breyanzi's efficacy should aid in securing favorable reimbursement and driving adoption.
Data presentations highlight BMS’ leadership and commitment to harnessing the full potential of cell therapy, with advances in blood cancers and beyond
Multiple analyses underscore durable efficacy and well-established safety profile of Breyanzi® (lisocabtagene maraleucel; liso-cel) in leukemia and several types of lymphoma
Expanded pipeline data across multiple modalities feature first survival results for a GPRC5D-directed CAR T, arlocabtagene autoleucel (arlo-cel; BMS-986393), and updated results from a Phase 1 study reinforcing potential of CD19 NEX-T® (BMS-986353) to deliver immune ‘reset’ among patients with severe refractory lupus
“Cell therapy is one of the fastest-growing modalities across our industry, and we’re committed to unlocking its full potential to deliver transformative treatments to patients with cancer and beyond,” said Anne Kerber, senior vice president, head of late clinical development, Hematology, Oncology and Cell Therapy (HOCT), Bristol Myers Squibb. “Our data on Breyanzi and Abecma at ASH reaffirm how our approved CAR T cell therapies continue to demonstrate favorable long-term outcomes, while results from our pipeline offer potential to address the unmet needs of patients with relapsed or refractory multiple myeloma and severe refractory autoimmune diseases.”
Key presentations include:
- Long-term analyses reinforcing the durable efficacy and well-established safety profile of Breyanzi® (lisocabtagene maraleucel; liso-cel) in large B-cell lymphoma (LBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL)
- New circulating tumor DNA (ctDNA) data from the Phase 3 TRANSFORM study supporting the superiority of Breyanzi to achieve deeper responses over the former standard of care in second-line LBCL
- New analysis highlighting global manufacturing capability, reliability and timely delivery for Abecma® (idecabtagene vicleucel; ide-cel) in relapsed or refractory multiple myeloma (RRMM)
- First overall and progression-free survival data for arlocabtagene autoleucel (arlo-cel; BMS-986393), a GPRC5D-directed CAR T cell therapy in RRMM
- Updated Phase 1 data for CD19 NEX-T® CAR T cell therapy (BMS-986353/CC-97540), highlighting its potential to make a meaningful impact for patients with severe, refractory autoimmune diseases including systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies, and multiple sclerosis
“We’re excited to disclose the progress of our robust pipeline, with promising early survival results for our GPRC5D-targeted cell therapy underscoring the first-in-class potential of arlocabtagene autoleucel for patients with relapsed or refractory multiple myeloma,” said Bryan Campbell, senior vice president, Head of Global Program Leaders, HOCT, Bristol Myers Squibb. “Beyond blood cancers, we’re encouraged by the continued results we are seeing with CD19 NEX-T in autoimmune diseases, like severe lupus, highlighting its possibility as a one-time treatment to provide sustained and treatment-free remission.”
Breyanzi Phase 1 TRANSCEND NHL Study Results: Abstract #3125
Five-year overall survival (OS) data from the Phase 1 TRANSCEND NHL 001 study support the deep and durable responses of Breyanzi in patients with relapsed or refractory LBCL (R/R LBCL) with median OS of 27.5 months (
Breyanzi Phase 3 TRANSFORM Study Results: Abstract #72
New ctDNA data from the Phase 3 TRANSFORM study support ctDNA as an early predictor of durable clinical benefit after second-line LBCL treatment with Breyanzi. Patients with undetectable ctDNA in the Breyanzi vs standard of care (SOC) arm had longer event-free survival (EFS) at all predefined time points and had statistically longer EFS at Day 126 which corresponds to post-transplant visit for SOC arm (SOC vs Breyanzi: HR, 3.89 [
Breyanzi Real-World Outcomes in Second-Line LBCL: Abstract #470 and Abstract #472
Real-world data from the Center for International Blood and Marrow Transplant Research (CIBMTR) Registry supported the use of Breyanzi as a second-line salvage therapy and autologous stem cell transplant in R/R LBCL regardless of age, including for younger (under 70 years) and older patients (70 years and older). At a median follow-up of 6.4 months (
Additionally, real-world data from the CIBMTR Registry supported the use of Breyanzi as a feasible and effective therapeutic option in real-world patients with R/R LBCL and secondary Central Nervous System (sCNS) involvement. At a median follow up of 12 months (
Breyanzi Phase 2 TRANSCEND FL Study Results: Abstract #4387
After two years of follow-up, patients with third-line-plus and second-line high-risk relapsed or refractory follicular lymphoma (R/R FL) who received a single administration of Breyanzi had ORR and CR rates above
Breyanzi Phase 1/2 TRANSCEND CLL 004 Study Results: Abstract #887
Primary analysis results from the Breyanzi plus ibrutinib combination cohort of the Phase 1/2 TRANSCEND CLL 004 trial showed that treatment with Breyanzi plus ibrutinib, a Bruton tyrosine kinase inhibitor (BTKi), resulted in deep remissions (
Global Manufacturing Results for Abecma: Abstract #3476
A new analysis of 4,117 RRMM patients who underwent leukapheresis for commercial Abecma between February 23, 2021, and May 1, 2024, as captured on the Cell Therapy 360® portal, found that the overall manufacturing success rate (MSR) for Abecma was
First Disclosure of Phase 1 Efficacy and Safety Results of arlocabtagene autoleucel (BMS-986393): Abstract #922
In an oral presentation, BMS showcased the first OS and progression-free survival (PFS) data for arlo-cel, a GPRC5D-targeted CAR T therapy. In the Phase 1 study, patients had three or more prior anti-multiple myeloma regimens including a proteasome inhibitor, an immunomodulatory agent, and anti-CD38 therapy. After a median follow-up of 16.1 months (range, 2.8-25.2) in efficacy-evaluable patients (n= 79), arlo-cel demonstrated durable responses, with ORR maintained at
These data support arlo-cel being investigated as a potential first-in-class treatment for heavily pretreated RRMM and its ongoing evaluation in the Phase 2 QUINTESSENTIAL study (NCT06297226).
Updated Data of Phase 1 Study of CD19-Directed CAR T BMS-986353: Abstract #2088
Updated data were presented from a Phase 1 study of CD19 NEX-T (BMS-986353) highlighting the promising efficacy and safety in patients with severe, refractory autoimmune diseases. Safety results were presented for 17 patients, including 2 patients with relapsing-remitting multiple sclerosis (MS), 3 patients with system sclerosis (SSc), 1 patient with idiopathic inflammatory myopathies (IIM), and 11 patients with systemic lupus erythematosus (SLE). In efficacy-evaluable patients with SLE (n=7), significant improvements in Systemic Lupus Erythematosus Disease Activity Index (median score reduction of 10 points at 1 month following BMS-986353 infusion) and Physician Global Assessment (median score reduction of
These results highlight the potential of BMS-986353 as a one-time infusion of CD19-directed CAR T cell therapy to reset the immune systems of patients with autoimmune diseases, which may provide treatment-free sustained remission.
Bristol Myers Squibb thanks the patients and investigators participating in these cell therapy clinical trials.
Please see the Important Safety Information section below, including Boxed WARNINGS for Breyanzi and Abecma.
About TRANSCEND NHL 001
TRANSCEND NHL 001 (NCT02631044) is an open-label, multicenter, pivotal, Phase 1, single-arm, seamless-design study to determine the safety, pharmacokinetics and antitumor activity of Breyanzi in patients with relapsed or refractory B-cell non-Hodgkin lymphoma, including diffuse large B-cell lymphoma, high-grade B-cell lymphoma, primary mediastinal B-cell lymphoma, follicular lymphoma Grade 3B and mantle cell lymphoma. The primary outcome measures are treatment-related adverse events, dose-limiting toxicities and overall response rate. Secondary outcome measures include complete response rate, duration of response, and progression-free survival.
About TRANSFORM
TRANSFORM (NCT03575351) is a pivotal, global, randomized, multicenter Phase 3 trial evaluating Breyanzi compared to current standard therapy regimens (platinum-based salvage chemotherapy followed by high-dose chemotherapy and HSCT in patients responding to salvage chemotherapy) in patients with large B-cell lymphoma (LBCL) that was primary refractory or relapsed within 12 months after CD20-antibody and anthracycline containing first-line therapy. Patients were randomized to receive Breyanzi or standard of care salvage therapy, including rituximab plus dexamethasone, high-dose cytarabine, and cisplatin (R-DHAP), rituximab plus ifosfamide, carboplatin and etoposide (R-ICE), or rituximab plus gemcitabine, dexamethasone and cisplatin (R-GDP) per the investigators’ choice before proceeding to high-dose chemotherapy (HDCT) and hematopoietic stem cell transplant (HSCT). The primary endpoint of the study was event-free survival (EFS), defined as time from randomization to death from any cause, progressive disease, failure to achieve complete response or partial response, or start of new antineoplastic therapy due to efficacy concerns, whichever occurs first. Complete response (CR) rate was a key secondary endpoint. Other efficacy endpoints included progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and duration of response (DOR).
About TRANSCEND CLL 004
TRANSCEND CLL 004 (NCT03331198) is a Phase 1/2 open-label, single-arm, multicenter study evaluating Breyanzi in patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma. The Phase 1 dose escalation portion of the study assessed the safety and recommended dose for the subsequent Phase 2 expansion cohort. The phase 1 dose-escalation portion includes cohorts assessing liso-cel monotherapy and liso-cel combined with ibrutinib. The Phase 2 portion of the study is evaluating Breyanzi at the recommended dose from the Phase 1 monotherapy arm. The primary endpoint of the Phase 2 portion of the study is complete response rate, including complete remission with incomplete bone marrow recovery, based on independent review committee according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2018 guidelines.
About Breyanzi
Breyanzi is a CD19-directed CAR T cell therapy with a 4-1BB costimulatory domain, which enhances the expansion and persistence of the CAR T cells. Breyanzi is made from a patient’s own T cells, which are collected and genetically reengineered to become CAR T cells that are then delivered via infusion as a one-time treatment.
Breyanzi is approved in the
Bristol Myers Squibb’s clinical development program for Breyanzi includes clinical studies in other types of lymphoma. For more information, visit clinicaltrials.gov.
Indications
BREYANZI is a CD19-directed genetically modified autologous T cell immunotherapy indicated for the treatment of:
-
adult patients with large B-cell lymphoma (LBCL), including diffuse large B-cell lymphoma (DLBCL) not otherwise specified (including DLBCL arising from indolent lymphoma), high-grade B cell lymphoma, primary mediastinal large B-cell lymphoma, and follicular lymphoma grade 3B, who have:
- refractory disease to first-line chemoimmunotherapy or relapse within 12 months of first-line chemoimmunotherapy; or
- refractory disease to first-line chemoimmunotherapy or relapse after first-line chemoimmunotherapy and are not eligible for hematopoietic stem cell transplantation (HSCT) due to comorbidities or age; or
- relapsed or refractory disease after two or more lines of systemic therapy.
Limitations of Use: BREYANZI is not indicated for the treatment of patients with primary central nervous system lymphoma.
- adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have received at least 2 prior lines of therapy, including a Bruton tyrosine kinase (BTK) inhibitor and a B-cell lymphoma 2 (BCL-2) inhibitor. This indication is approved under accelerated approval based on response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).
- adult patients with relapsed or refractory follicular lymphoma (FL) who have received 2 or more prior lines of systemic therapy. This indication is approved under accelerated approval based on response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).
- adult patients with relapsed or refractory mantle cell lymphoma (MCL) who have received at least 2 prior lines of systemic therapy, including a Bruton tyrosine kinase (BTK) inhibitor.
Important Safety Information
WARNING: CYTOKINE RELEASE SYNDROME, NEUROLOGIC TOXICITIES, AND SECONDARY HEMATOLOGICAL MALIGNANCIES
- Cytokine Release Syndrome (CRS), including fatal or life-threatening reactions, occurred in patients receiving BREYANZI. Do not administer BREYANZI to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab with or without corticosteroids.
- Neurologic toxicities, including fatal or life-threatening reactions, occurred in patients receiving BREYANZI, including concurrently with CRS, after CRS resolution, or in the absence of CRS. Monitor for neurologic events after treatment with BREYANZI. Provide supportive care and/or corticosteroids as needed.
- T cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T cell immunotherapies, including BREYANZI.
- BREYANZI is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the BREYANZI REMS.
Cytokine Release Syndrome
Cytokine release syndrome (CRS), including fatal or life-threatening reactions, occurred following treatment with BREYANZI. In clinical trials of BREYANZI, which enrolled a total of 702 patients with non-Hodgkin lymphoma (NHL), CRS occurred in
Serious events that may be associated with CRS include cardiac arrhythmias (including atrial fibrillation and ventricular tachycardia), cardiac arrest, cardiac failure, diffuse alveolar damage, renal insufficiency, capillary leak syndrome, hypotension, hypoxia, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS).
Ensure that 2 doses of tocilizumab are available prior to infusion of BREYANZI.
Neurologic Toxicities
Neurologic toxicities that were fatal or life-threatening, including immune effector cell-associated neurotoxicity syndrome (ICANS), occurred following treatment with BREYANZI. Serious events including cerebral edema and seizures occurred with BREYANZI. Fatal and serious cases of leukoencephalopathy, some attributable to fludarabine, also occurred.
In clinical trials of BREYANZI, CAR T cell-associated neurologic toxicities occurred in
The most common neurologic toxicities (≥
CRS and Neurologic Toxicities Monitoring
Monitor patients daily for at least 7 days following BREYANZI infusion at a REMS-certified healthcare facility for signs and symptoms of CRS and neurologic toxicities and assess for other causes of neurological symptoms. Monitor patients for signs and symptoms of CRS and neurologic toxicities for at least 4 weeks after infusion and treat promptly. At the first sign of CRS, institute treatment with supportive care, tocilizumab, or tocilizumab and corticosteroids as indicated. Manage neurologic toxicity with supportive care and/or corticosteroid as needed. Counsel patients to seek immediate medical attention should signs or symptoms of CRS or neurologic toxicity occur at any time.
BREYANZI REMS
Because of the risk of CRS and neurologic toxicities, BREYANZI is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the BREYANZI REMS. The required components of the BREYANZI REMS are:
- Healthcare facilities that dispense and administer BREYANZI must be enrolled and comply with the REMS requirements.
- Certified healthcare facilities must have on-site, immediate access to tocilizumab.
- Ensure that a minimum of 2 doses of tocilizumab are available for each patient for infusion within 2 hours after BREYANZI infusion, if needed for treatment of CRS.
Further information is available at www.BreyanziREMS.com, or contact Bristol Myers Squibb at 1-866-340-7332.
Hypersensitivity Reactions
Allergic reactions may occur with the infusion of BREYANZI. Serious hypersensitivity reactions, including anaphylaxis, may be due to dimethyl sulfoxide (DMSO).
Serious Infections
Severe infections, including life-threatening or fatal infections, have occurred in patients after BREYANZI infusion. In clinical trials of BREYANZI, infections of any grade occurred in
Febrile neutropenia developed after BREYANZI infusion in
Monitor patients for signs and symptoms of infection before and after BREYANZI administration and treat appropriately. Administer prophylactic antimicrobials according to standard institutional guidelines. Avoid administration of BREYANZI in patients with clinically significant, active systemic infections.
Viral reactivation: Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with drugs directed against B cells. In clinical trials of BREYANZI, 35 of 38 patients with a prior history of HBV were treated with concurrent antiviral suppressive therapy. Perform screening for HBV, HCV, and HIV in accordance with clinical guidelines before collection of cells for manufacturing. In patients with prior history of HBV, consider concurrent antiviral suppressive therapy to prevent HBV reactivation per standard guidelines.
Prolonged Cytopenias
Patients may exhibit cytopenias not resolved for several weeks following lymphodepleting chemotherapy and BREYANZI infusion. In clinical trials of BREYANZI, Grade 3 or higher cytopenias persisted at Day 29 following BREYANZI infusion in
Hypogammaglobulinemia
B-cell aplasia and hypogammaglobulinemia can occur in patients receiving BREYANZI. In clinical trials of BREYANZI, hypogammaglobulinemia was reported as an adverse reaction in
Live vaccines: The safety of immunization with live viral vaccines during or following BREYANZI treatment has not been studied. Vaccination with live virus vaccines is not recommended for at least 6 weeks prior to the start of lymphodepleting chemotherapy, during BREYANZI treatment, and until immune recovery following treatment with BREYANZI.
Secondary Malignancies
Patients treated with BREYANZI may develop secondary malignancies. T cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T cell immunotherapies, including BREYANZI. Mature T cell malignancies, including CAR-positive tumors, may present as soon as weeks following infusion, and may include fatal outcomes. Monitor lifelong for secondary malignancies. In the event that a secondary malignancy occurs, contact Bristol Myers Squibb at 1-888-805-4555 for reporting and to obtain instructions on collection of patient samples for testing.
Effects on Ability to Drive and Use Machines
Due to the potential for neurologic events, including altered mental status or seizures, patients receiving BREYANZI are at risk for developing altered or decreased consciousness or impaired coordination in the 8 weeks following BREYANZI administration. Advise patients to refrain from driving and engaging in hazardous occupations or activities, such as operating heavy or potentially dangerous machinery, for at least 8 weeks.
Immune Effector Cell-Associated Hemophagocytic Lymphohistiocytosis-Like Syndrome (IEC-HS)
Immune Effector Cell-Associated Hemophagocytic Lymphohistiocytosis-Like Syndrome (IEC-HS), including fatal or life-threatening reactions, occurred following treatment with BREYANZI. Three of 89 (
Adverse Reactions
The most common adverse reaction(s) (incidence ≥
- LBCL are fever, cytokine release syndrome, fatigue, musculoskeletal pain, and nausea. The most common Grade 3-4 laboratory abnormalities include lymphocyte count decrease, neutrophil count decrease, platelet count decrease, and hemoglobin decrease.
- CLL/SLL are cytokine release syndrome, encephalopathy, fatigue, musculoskeletal pain, nausea, edema, and diarrhea. The most common Grade 3-4 laboratory abnormalities include neutrophil count decrease, white blood cell decrease, hemoglobin decrease, platelet count decrease, and lymphocyte count decrease.
- FL is cytokine release syndrome. The most common Grade 3-4 laboratory abnormalities include lymphocyte count decrease, neutrophil count decrease, and white blood cell decrease.
- MCL are cytokine release syndrome, fatigue, musculoskeletal pain, and encephalopathy. The most common Grade 3-4 laboratory abnormalities include neutrophil count decrease, white blood cell decrease, and platelet count decrease.
Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide.
About Abecma
Abecma 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 after two or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. Abecma is being jointly developed and commercialized in the
Abecma
ABECMA (idecabtagene vicleucel) 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 after two or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.
WARNING: CYTOKINE RELEASE SYNDROME, NEUROLOGIC TOXICITIES, HLH/MAS, PROLONGED CYTOPENIA and SECONDARY HEMATOLOGICAL MALIGNANCIES
- Cytokine Release Syndrome (CRS), including fatal or life-threatening reactions, occurred in patients following treatment with ABECMA. Do not administer ABECMA to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab or tocilizumab and corticosteroids.
- Neurologic Toxicities, which may be severe or life-threatening, occurred following treatment with ABECMA, including concurrently with CRS, after CRS resolution, or in the absence of CRS. Monitor for neurologic events after treatment with ABECMA. Provide supportive care and/or corticosteroids as needed.
- Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS) including fatal and life-threatening reactions, occurred in patients following treatment with ABECMA. HLH/MAS can occur with CRS or neurologic toxicities.
- Prolonged Cytopenia with bleeding and infection, including fatal outcomes following stem cell transplantation for hematopoietic recovery, occurred following treatment with ABECMA.
- T cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T cell immunotherapies, including ABECMA.
- ABECMA is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ABECMA REMS.
Warnings and Precautions:
Early Death: In KarMMa-3, a randomized (2:1), controlled trial, a higher proportion of patients experienced death within 9 months after randomization in the ABECMA arm (45/254;
Cytokine Release Syndrome (CRS): CRS, including fatal or life-threatening reactions, occurred following treatment with ABECMA. Among patients receiving ABECMA for relapsed refractory multiple myeloma in the KarMMa and KarMMa-3 studies (N=349), CRS occurred in
The most common manifestations of CRS (greater than or equal to
Identify CRS based on clinical presentation. Evaluate for and treat other causes of fever, hypoxia, and hypotension. CRS has been reported to be associated with findings of HLH/MAS, and the physiology of the syndromes may overlap. HLH/MAS is a potentially life-threatening condition. In patients with progressive symptoms of CRS or refractory CRS despite treatment, evaluate for evidence of HLH/MAS.
Of the 349 patients who received ABECMA in clinical trials, 226 (
Monitor patients at least daily for 7 days following ABECMA infusion at the REMS-certified healthcare facility for signs or symptoms of CRS and monitor patients for signs or symptoms of CRS for at least 4 weeks after ABECMA infusion. At the first sign of CRS, institute treatment with supportive care, tocilizumab and/or corticosteroids as indicated. Ensure that a minimum of 2 doses of tocilizumab are available prior to infusion of ABECMA. Counsel patients to seek immediate medical attention should signs or symptoms of CRS occur at any time.
Neurologic Toxicities: Neurologic toxicities, including immune-effector cell-associated neurotoxicity (ICANS), which may be severe or life- threatening, occurred concurrently with CRS, after CRS resolution, or in the absence of CRS following treatment with ABECMA.
In patients receiving ABECMA in the KarMMa and KarMMa-3 studies, CAR T cell-associated neurotoxicity occurred in
At the safety update for KarMMa-3 study, one patient developed fatal neurotoxicity 43 days after ABECMA. In KarMMa, one patient had ongoing Grade 2 neurotoxicity at the time of death. Two patients had ongoing Grade 1 tremor at the time of data cutoff.
Cerebral edema has been associated with ABECMA in a patient in another study in multiple myeloma. Grade 3 myelitis and Grade 3 parkinsonism have occurred after treatment with ABECMA in another study in multiple myeloma.
Monitor patients at least daily for 7 days following ABECMA infusion at the REMS-certified healthcare facility for signs or symptoms of neurologic toxicities and monitor patients for signs or symptoms of neurologic toxicities for at least 4 weeks after ABECMA infusion and treat promptly. Rule out other causes of neurologic symptoms. Neurologic toxicity should be managed with supportive care and/or corticosteroids as needed. Counsel patients to seek immediate medical attention should signs or symptoms occur at any time.
Hemophagocytic Lymphohistiocytosis (HLH)/Macrophage Activation Syndrome (MAS): In patients receiving ABECMA in the KarMMa and KarMMa-3 studies, HLH/MAS occurred in
In KarMMa-3, one patient had Grade 5, two patients had Grade 4 and two patients had Grade 3 HLH/MAS. The patient with Grade 5 HLH/MAS also had Grade 5 candida sepsis and Grade 5 CRS. In another patient who died due to stroke, the Grade 4 HLH/MAS had resolved prior to death. Two cases of Grade 3 and one case of Grade 4 HLH/MAS had resolved.
In KarMMa, one patient treated in the 300 x 106 CAR-positive T cells dose cohort developed fatal multi-organ HLH/MAS with CRS. In another patient with fatal bronchopulmonary aspergillosis, HLH/MAS was contributory to the fatal outcome. Three cases of Grade 2 HLH/MAS resolved.
HLH/MAS is a potentially life-threatening condition with a high mortality rate if not recognized early and treated. Treatment of HLH/MAS should be administered per institutional guidelines.
ABECMA REMS: Due to the risk of CRS and neurologic toxicities, ABECMA is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ABECMA REMS. Further information is available at www.AbecmaREMS.com or contact Bristol Myers Squibb at 1-866-340-7332.
Hypersensitivity Reactions: Allergic reactions may occur with the infusion of ABECMA. Serious hypersensitivity reactions, including anaphylaxis, may be due to dimethyl sulfoxide (DMSO) in ABECMA.
Infections: ABECMA should not be administered to patients with active infections or inflammatory disorders. Severe, life-threatening, or fatal infections occurred in patients after ABECMA infusion.
In all patients receiving ABECMA in the KarMMa and KarMMa-3 studies, infections (all grades) occurred in
Monitor patients for signs and symptoms of infection before and after ABECMA infusion and treat appropriately. Administer prophylactic, pre-emptive, and/or therapeutic antimicrobials according to standard institutional guidelines.
Febrile neutropenia was observed in
Viral Reactivation: Cytomegalovirus (CMV) infection resulting in pneumonia and death has occurred following ABECMA administration. Monitor and treat for CMV reactivation in accordance with clinical guidelines. Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with drugs directed against plasma cells. Perform screening for CMV, HBV, hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in accordance with clinical guidelines before collection of cells for manufacturing. Consider antiviral therapy to prevent viral reactivation per local institutional guidelines/clinical practice.
Prolonged Cytopenias: In patients receiving ABECMA in the KarMMa and KarMMa-3 studies,
Monitor blood counts prior to and after ABECMA infusion. Manage cytopenia with myeloid growth factor and blood product transfusion support according to local institutional guidelines.
Hypogammaglobulinemia: In all patients receiving ABECMA in the KarMMa and KarMMa-3 studies, hypogammaglobulinemia was reported as an adverse event in
Hypogammaglobulinemia either as an adverse reaction or laboratory IgG level below 500 mg/dL after infusion occurred in
Monitor immunoglobulin levels after treatment with ABECMA and administer IVIG for IgG <400 mg/dl. Manage appropriately per local institutional guidelines, including infection precautions and antibiotic or antiviral prophylaxis.
Use of Live Vaccines: The safety of immunization with live viral vaccines during or after ABECMA treatment has not been studied. Vaccination with live virus vaccines is not recommended for at least 6 weeks prior to the start of lymphodepleting chemotherapy, during ABECMA treatment, and until immune recovery following treatment with ABECMA.
Secondary Malignancies: Patients treated with ABECMA may develop secondary malignancies. In KarMMa-3, myeloid neoplasms (four cases of myelodysplastic syndrome and one case of acute myeloid leukemia) occurred in
T cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T cell immunotherapies, including ABECMA. Mature T cell malignancies, including CAR-positive tumors, may present as soon as weeks following infusion, and may include fatal outcomes.
Monitor life-long for secondary malignancies. In the event that a secondary malignancy occurs, contact Bristol Myers Squibb at 18888054555 for reporting and to obtain instructions on collection of patient samples for testing of secondary malignancy.
Effects on Ability to Drive and Operate Machinery: Due to the potential for neurologic events, including altered mental status or seizures, patients receiving ABECMA are at risk for altered or decreased consciousness or coordination in the 8 weeks following ABECMA infusion. Advise patients to refrain from driving and engaging in hazardous occupations or activities, such as operating heavy or potentially dangerous machinery, during this initial period.
Adverse Reactions: The most common nonlaboratory adverse reactions (incidence greater than or equal to
Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide.
Bristol Myers Squibb: Unlocking the Full Potential of Cell Therapy
A pioneer in harnessing the immune system to fight cancer and an established leader in cell therapy, Bristol Myers Squibb is uniquely positioned to unlock the full potential of this technology across blood cancers and within new frontiers, including autoimmune disease.
Bristol Myers Squibb is currently the only company with two approved CAR T cell therapies with two distinct targets, available in major markets around the world. Our bold vision for the future is one in which hundreds of thousands of patients can be treated with cell therapy’s transformational potential.
The building blocks to realize this ambition—a promising and differentiated pipeline, extensive translational and clinical data sets, a deep bench of talent, and robust manufacturing capabilities—are in our cells. We are laser-focused on advancing the field of cell therapy toward a true revolution for patients. Learn more about the science behind cell therapy and ongoing progress at Bristol Myers Squibb here.
Bristol Myers Squibb: Creating a Better Future for People with Cancer
Bristol Myers Squibb is inspired by a single vision—transforming patients’ lives through science. The goal of the company’s cancer research is to deliver medicines that offer each patient a better, healthier life and to make cure a possibility. Building on a legacy across a broad range of cancers that have changed survival expectations for many, Bristol Myers Squibb researchers are exploring new frontiers in personalized medicine, and through innovative digital platforms, are turning data into insights that sharpen their focus. Deep understanding of causal human biology, cutting-edge capabilities and differentiated research platforms uniquely position the company to approach cancer from every angle.
Cancer can have a relentless grasp on many parts of a patient’s life, and Bristol Myers Squibb is committed to taking actions to address all aspects of care, from diagnosis to survivorship. As a leader in cancer care, Bristol Myers Squibb is working to empower all people with cancer to have a better future.
Learn more about the science behind cell therapy and ongoing research at Bristol Myers Squibb here.
About Bristol Myers Squibb
Bristol Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information about Bristol Myers Squibb, visit us at BMS.com or follow us on LinkedIn, X, YouTube, Facebook and Instagram.
Cautionary Statement Regarding Forward-Looking Statements
This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 regarding, among other things, the research, development and commercialization of pharmaceutical products. All statements that are not statements of historical facts are, or may be deemed to be, forward-looking statements. Such forward-looking statements are based on current expectations and projections about our future financial results, goals, plans and objectives and involve inherent risks, assumptions and uncertainties, including internal or external factors that could delay, divert or change any of them in the next several years, that are difficult to predict, may be beyond our control and could cause our future financial results, goals, plans and objectives to differ materially from those expressed in, or implied by, the statements. These risks, assumptions, uncertainties and other factors include, among others, that future study results may not be consistent with the results to date, that the products, product candidates, treatments and combination treatments described in this release may not receive regulatory approval for the indications described in this release, any marketing approvals, if granted, may have significant limitations on their use, and, if approved, whether such products, product candidates, treatments and combination treatments for such indications will be commercially successful. No forward-looking statement can be guaranteed. Forward-looking statements in this press release should be evaluated together with the many risks and uncertainties that affect Bristol Myers Squibb’s business and market, particularly those identified in the cautionary statement and risk factors discussion in Bristol Myers Squibb’s Annual Report on Form 10-K for the year ended December 31, 2023, as updated by our subsequent Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and other filings with the Securities and Exchange Commission. The forward-looking statements included in this document are made only as of the date of this document and except as otherwise required by applicable law, Bristol Myers Squibb undertakes no obligation to publicly update or revise any forward-looking statement, whether as a result of new information, future events, changed circumstances or otherwise.
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