Bristol Myers Squibb to Highlight More than 80 Abstracts at ASH 2021 Demonstrating Strength of Innovative Therapeutic Platforms Improving Outcomes for a Broad Range of Hematologic Diseases
Bristol Myers Squibb (NYSE: BMY) announced a significant presence at the 63rd ASH Annual Meeting, showcasing research on hematologic diseases, including data from over 80 studies. Key presentations include results from the Phase 3 TRANSFORM study of Breyanzi (lisocabtagene maraleucel) against standard care for relapsed or refractory large B-cell lymphoma and new findings on CELMoD therapies like iberdomide. The company highlights its commitment to innovation in treatments for multiple myeloma, lymphoma, and myeloid diseases aimed at improving patient outcomes.
- Presentation of Phase 3 TRANSFORM study results for Breyanzi against standard care.
- Over 80 company-sponsored studies to be featured at the ASH Annual Meeting.
- New findings presented for CELMoD therapies which could enhance treatment options.
- Potential risks associated with Breyanzi and Abecma include severe side effects like cytokine release syndrome and neurologic toxicities.
- High rates of infections (up to 70%) reported post-Abecma treatment.
- Concerns over prolonged cytopenias and secondary malignancies in treated patients.
First presentation of data from the Phase 3 TRANSFORM study of CD19-directed CAR T cell therapy Breyanzi (lisocabtagene maraleucel) in second-line relapsed or refractory (R/R) large B-cell lymphoma
Research from industry-leading multiple myeloma program with new analyses for the first-in-class anti-BCMA CAR T cell therapy, Abecma (idecabtagene vicleucel), as well as studies in heavily-treated disease highlighting CELMoD®s, with new safety and efficacy results for iberdomide and first presentation of combination data with CC-92480
First clinical results for anti-SIRPα antibody CC-95251 and CELMoD® CC-99282 in patients with R/R non-Hodgkin’s lymphoma showcasing pipeline potential through multiple modalities
Key data being presented by
- First presentation of results from pivotal Phase 3 TRANSFORM study evaluating CD19-directed chimeric antigen receptor (CAR) T cell therapy Breyanzi (lisocabtagene maraleucel) head-to-head against the current standard of care treatment approach for second-line relapsed or refractory (R/R) large B-cell lymphoma (LBCL)
- Two-year follow-up data from the pivotal TRANSCEND NHL 001 study of Breyanzi in third-line and later R/R LBCL
- First clinical results for anti-SIRPα antibody CC-95251 plus rituximab, as well as first clinical results for CELMoD® CC-99282, both in patients with R/R non-Hodgkin’s lymphoma
- First disclosure of safety and efficacy results from dose expansion of the MM-001 study evaluating CELMoD® iberdomide in combination with dexamethasone in patients with R/R multiple myeloma
- First disclosure of preliminary results from the Phase 1/2 MM-002 study of CELMoD® CC-92480 in combination with dexamethasone and bortezomib in patients with R/R multiple myeloma
- Further analyses from the pivotal KarMMa trial in R/R multiple myeloma evaluated baseline predictors of complete responses and outcomes for patients treated with subsequent anti-myeloma therapies, including alternative B-cell maturation antigen (BCMA)-directed therapies, after treatment with Abecma (idecabtagene vicleucel),the first-in-class BCMA-directed CAR T cell therapy
- Abstracts highlighting multiple Bristol Myers Squibb’s therapies in hard-to-treat myeloid diseases, including longer-term data and analyses of different acute myeloid leukemia subtypes and baseline characteristics with Onureg® (azacitidine tablets) from the Phase 3 QUAZAR® AML-001 study and safety with Inrebic® (fedratinib) from the Phase 3b FREEDOM trial in myelofibrosis
- Updated analyses of Reblozyl® (luspatercept-aamt) from the Phase 2 BEYOND study in beta thalassemia and from the Phase 3 MEDALIST study in lower-risk myelodysplastic syndromes
“Our presence at ASH continues our longstanding commitment to hematology and underscores the potential of our innovative research platforms to deliver meaningful, new treatment options for people with unmet needs living with hematologic diseases,” said
Selected Bristol Myers Squibb studies at the 63rd ASH Annual Meeting and Exposition include:
Abstract Title |
Author |
Presentation Type/# |
Session Title |
Session Date/Time |
Acute Myeloid Leukemia |
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Prognostic Impact of NPM1 and FLT3 Mutations at Diagnosis and Presence of Measurable Residual Disease (MRD) after Intensive Chemotherapy (IC) for Patients with Acute Myeloid Leukemia (AML) in Remission: Outcomes from the QUAZAR AML-001 Trial of Oral Azacitidine (Oral-AZA) Maintenance |
Hartmut Döhner |
Oral Abstract #804 |
617. Acute Myeloid Leukemia: Biomarkers, Molecular Markers and Minimal Residual Disease in Diagnosis and Prognosis: New options of risk assessment and prediction of therapy response in AML |
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Long-term Overall Survival (OS) with Oral Azacitidine (Oral-AZA) in Patients with Acute Myeloid Leukemia (AML) in First Remission after Intensive Chemotherapy (IC): Updated Results from the Phase 3 QUAZAR AML-001 Trial |
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Oral Abstract #871 |
615. Acute Myeloid Leukemias: Commercially Available Therapies, Excluding Transplantation and Cellular Immunotherapies: Updates in treatment for high-risk AML |
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Beta Thalassemia |
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Luspatercept Redistributes Body Iron to the Liver in Transfusion-Dependent-Thalassemia (TDT) During Erythropoietic Response |
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Oral Abstract #761
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102. Iron Homeostasis and Biology: Disorders of Iron and Heme and Novel Treatments |
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Luspatercept Improves Health-Related Quality of Life (HRQoL) Symptoms and RBC Transfusion Burden in Patients with Non-Transfusion-Dependent β-thalassemia (NTDT) in the BEYOND Trial |
Antonis Kattamis |
Poster Abstract #3081 |
112. Thalassemia and Globin Gene Regulation: Poster III |
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Graft vs. Host Disease |
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Overall Survival of Patients Treated with Abatacept in Combination with a Calcineurin Inhibitor and Methotrexate After Allogeneic Hematopoietic Stem Cell Transplantation - Analysis of the |
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Poster Abstract #3912 |
722. Allogeneic Transplantation: Acute and Chronic GVHD, Immune Reconstitution: Poster III |
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Lymphoma |
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Lisocabtagene Maraleucel (liso-cel), a CD19-Directed Chimeric Antigen Receptor (CAR) T Cell Therapy, Versus Standard of Care (SOC) with Salvage Chemotherapy (CT) Followed by Autologous Stem Cell Transplantation (ASCT) as Second-Line (2L) Treatment in Patients (Pts) with Relapsed or Refractory (R/R) Large B-Cell Lymphoma (LBCL): Results from the Randomized Phase 3 TRANSFORM Study |
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Oral Abstract #91
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704. Cellular Immunotherapies: Cellular Therapies for Lymphomas |
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Ruxolitinib Plus Nivolumab in Patients with R/R Hodgkin Lymphoma after Failure of Check-Point Inhibitors: Preliminary Report on Safety and Efficacy |
Veronika Bachanova
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Oral Abstract #230
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624. Hodgkin Lymphomas and T/NK cell Lymphomas: Hodgkin Lymphoma Clinical Trials Hematology Disease Topics & Pathways: Clinical Trials |
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Nivolumab First-Line Therapy for Elderly Hodgkin Lymphoma Patients: a LYSA Phase II Study
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Oral Abstract #232
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624. Hodgkin Lymphomas and T/NK cell Lymphomas: Hodgkin Lymphoma Clinical Trials |
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OUTREACH: Results from a Phase 2 Study of Lisocabtagene Maraleucel (liso-cel) Administered as Inpatient (Inpt) or Outpatient (Outpt) Treatment in the Nonuniversity Setting in Patients (Pts) with R/R Large B-Cell Lymphoma (LBCL) |
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Poster Abstract #1762
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704. Cellular Immunotherapies: Clinical: Poster I |
5:30 –
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Six-Year Results from the Phase 3 Randomized Study Relevance Show Similar Outcomes for Previously Untreated Follicular Lymphoma Patients Receiving Lenalidomide Plus Rituximab (R2) Versus Rituximab-Chemotherapy Followed By Rituximab Maintenance |
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Poster Abstract #2417
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623. Mantle Cell, Follicular, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster II |
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Differential Effects of Iberdomide Versus Revlimid on Leukocyte Trafficking, Immune Activation and DLBCL Tumor Cell Killing |
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Oral Abstract #718
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622. Lymphomas: Translational-Non-Genetic: Lymphoma biology |
3:30 PM |
Completed Induction Phase Analysis of MAGNIFY: Phase 3b Study of Lenalidomide + Rituximab (R2) Followed By Maintenance in Relapsed/Refractory Indolent Non-Hodgkin Lymphoma |
Frederick Lansigan
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Oral Abstract #812
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623. Mantle Cell, Follicular, and Other B-Cell Lymphomas: Clinical and Epidemiological: Follicular Lymphoma: Advances in Treatment Approaches |
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Discovery and Preclinical Characterization of CC-95251, an Anti-SIRPa Antibody that Enhances Macrophage-Mediated Phagocytosis of Non-Hodgkin Lymphoma (NHL) Cells when Combined with Rituximab |
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Poster Abstract #2271
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605. Molecular Pharmacology and Drug Resistance: Lymphoid Neoplasms: Poster II |
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Characteristics of Post-Infusion Chimeric Antigen Receptor (CAR) T Cells and Endogenous T Cells Associated with Early and Long-term Response in Lisocabtagene Maraleucel (liso-cel)–Treated Relapsed or Refractory (R/R) Large B-Cell Lymphoma (LBCL) |
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Poster Abstract #2417
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704. Cellular Immunotherapies: Clinical: Poster III |
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Two-Year Follow-up of TRANSCEND NHL 001, a Multicenter Phase 1 Study of Lisocabtagene Maraleucel (liso-cel) in Relapsed or Refractory (R/R) Large B-Cell Lymphomas (LBCL) |
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Poster Abstract #2840
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704. Cellular Immunotherapies: Clinical: Poster III |
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Cost-effectiveness of Liso-cel versus Axi-cel for Treatment of Relapsed or Refractory Large B-Cell Lymphoma |
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Poster Abstract #3003
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902. Health Services Research—Lymphoid Malignancies: Poster II |
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Clinical Activity of CC-99282, a Novel, Oral Small Molecule Cereblon E3 Ligase Modulator (CELMoD) Agent, in Patients (Pts) with Relapsed or Refractory Non-Hodgkin Lymphoma (R/R NHL) – First Results from a Phase 1, Open-Label Study |
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Poster Abstract #3574 |
626. Aggressive Lymphomas: Prospective Therapeutic Trials: Poster III |
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Multiple Myeloma |
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Iberdomide (IBER) in Combination with Dexamethasone (DEX) in Patients (pts) with Relapsed/Refractory Multiple Myeloma (RRMM): Results from the Dose-Expansion Phase of the CC-220-MM-001 Trial |
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Oral Abstract #162 |
653. Myeloma and Plasma Cell Dyscrasias: Clinical-Prospective Therapeutic Trials: Novel Targets and Amyloid |
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Real-World Treatment Patterns and Clinical, Economic, and Humanistic Burden in Triple-Class Refractory Multiple Myeloma: Analysis of the CONNECT® Multiple Myeloma (MM) Disease Registry |
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Oral Abstract #117 |
905. |
Saturday, December 11,
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Baseline Correlates of Complete Response to Idecabtagene Vicleucel (ide-cel, bb2121), a BCMA-Directed CAR T Cell Therapy in Patients with Relapsed and Refractory Multiple Myeloma: Subanalysis of the KarMMa Trial |
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Poster Abstract #1739
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704. Cellular Immunotherapies: Clinical: Poster I |
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Matching-Adjusted Indirect Comparisons of Efficacy Outcomes in Patients with Relapsed and Refractory Multiple Myeloma for Idecabtagene Vicleucel (KarMMa) vs. Selinexor Plus Dexamethasone (STORM Part 2) and Belantamab Mafodontin (DREAMM-2): Updated Analysis with Longer Follow-up |
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Poster Abstract #1978
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905. Outcomes Research—Lymphoid Malignancies: Poster I |
5:30 –
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Updated Clinical and Correlative Results From the Phase I CRB-402 Study of the BCMA-Targeted CAR-T Cell Therapy bb21217 in Patients with Relapsed and Refractory Multiple Myeloma |
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Oral Abstract #548
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Cellular Immunotherapies: Cellular Therapies for Myeloma |
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CC-92480, a Potent, Novel Cereblon E3 Ligase Modulator (CELMoD) Agent, in Combination with Dexamethasone (DEX) and Bortezomib (BORT) in Patients (pts) with Relapsed/Refractory Multiple Myeloma (RRMM): Preliminary Results from the Phase 1/2 Study CC-92480-MM-002 |
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Poster Abstract #2731 |
653. Myeloma and Plasma Cell Dyscrasias: Clinical-Prospective Therapeutic Trials: Poster II |
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Subsequent Anti-myeloma Therapy after Idecabtagene Vicleucel (Ide-cel, bb2121) Treatment in Patients with Relapsed/Refractory Multiple Myeloma from the KarMMa Study |
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Poster Abstract #2743
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653. Myeloma and Plasma Cell Dyscrasias: Clinical-Prospective Therapeutic Trials: Poster II |
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Updated Health-Related Quality of Life Results from the KarMMa Clinical Study in Patients with Relapsed and Refractory Multiple Myeloma Treated with the B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T Cell Therapy Idecabtagene Vicleucel (ide-cel, bb2121) |
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Poster Abstract #2835 |
704. Cellular Immunotherapies: Clinical: Poster II |
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Idecabtagene Vicleucel (ide-cel, bb2121), a B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T Cell Therapy: Qualitative Analyses of Post-Treatment Interviews (Months 6–24) for Patients with Relapsed and Refractory Multiple Myeloma in the KarMMa Clinical Trial |
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Poster Abstract #3041 |
Session |
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Large-Scale Mass Cytometry Reveals Significant Activation of Innate and Adaptive Immunity in Bone Marrow Tumor Microenvironment of Iberdomide-Treated Myeloma Patients |
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Oral Abstract #730
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651. Multiple Myeloma and Plasma Cell Dyscrasias: Basic and Translational: The Myeloma Immune Microenvironment |
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Myelodysplastic Syndrome |
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Treatment Duration and Exposure Adjusted Safety Analysis in the MEDALIST Study (luspatercept) |
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Poster Abstract #1524 |
637. Myelodysplastic Syndromes — Clinical and Epidemiological: Poster I |
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Myelofibrosis |
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Safety and Tolerability of Fedratinib, an Oral Inhibitor of Janus Kinase 2 (JAK2), in Patients with Intermediate- or High-risk Myelofibrosis (MF) Previously Treated with Ruxolitinib: Results from the Phase 3b FREEDOM Trial |
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Oral Abstract #389 |
634. Myeloproliferative Syndromes: Clinical and Epidemiological: Novel Therapies for MPNs and JAK inhibitors for Myelofibrosis |
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Spleen and Symptom Responses with Fedratinib (FEDR) Patients with Myelofibrosis (MF) and Substantial Splenomegaly |
Jean‐Jacques Kiladjian |
Poster Abstract #2576 |
634. Myeloproliferative Syndromes: Clinical and Epidemiological: Poster II |
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BREYANZI
Breyanzi is a CD19-directed chimeric antigen receptor (CAR) T cell therapy with a defined composition and 4-1BB costimulatory domain. Breyanzi is administered as a defined composition to reduce variability of the CD8 and CD4 component dose. The 4-1BB signaling domain enhances the expansion and persistence of the CAR T cells.
Indications
Breyanzi is approved by the
BOXED WARNING: CYTOKINE RELEASE SYNDROME and NEUROLOGIC TOXICITIES
- 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.
- BREYANZI is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the BREYANZI REMS.
Cytokine Release Syndrome (CRS)
CRS, including fatal or life-threatening reactions, occurred following treatment with BREYANZI. CRS occurred in
Among patients with CRS, the most common manifestations of CRS include fever (
Ensure that 2 doses of tocilizumab are available prior to infusion of BREYANZI. Sixty-one of 268 (
Neurologic Toxicities
Neurologic toxicities that were fatal or life-threatening, occurred following treatment with BREYANZI. CAR T cell-associated neurologic toxicities occurred in
Seventy-eight (78) of 95 (
Neurologic toxicity resolved in three patients before the onset of CRS. Eighteen patients experienced neurologic toxicity after resolution of CRS.
The most common neurologic toxicities included encephalopathy (
CRS and Neurologic Toxicities Monitoring
Monitor patients daily at a certified healthcare facility during the first week following infusion, for signs and symptoms of CRS and neurologic toxicities. Monitor patients for signs and symptoms of CRS and neurologic toxicities for at least 4 weeks after infusion; evaluate and treat promptly. Counsel patients to seek immediate medical attention should signs or symptoms of CRS or neurologic toxicity occur at any time. At the first sign of CRS, institute treatment with supportive care, tocilizumab or tocilizumab and corticosteroids as indicated.
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.
- Certified healthcare facilities must ensure that healthcare providers who prescribe, dispense, or administer BREYANZI are trained on the management of CRS and neurologic toxicities.
Further information is available at www.BreyanziREMS.com, or contact
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. Infections (all grades) occurred in
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. Ten of the 11 patients in the TRANSCEND study with a prior history of HBV were treated with concurrent antiviral suppressive therapy to prevent HBV reactivation during and after treatment with BREYANZI. Perform screening for HBV, HCV, and HIV in accordance with clinical guidelines before collection of cells for manufacturing.
Prolonged Cytopenias
Patients may exhibit cytopenias not resolved for several weeks following lymphodepleting chemotherapy and BREYANZI infusion. Grade 3 or higher cytopenias persisted at Day 29 following BREYANZI infusion in
Hypogammaglobulinemia
B-cell aplasia and hypogammaglobulinemia can occur in patients receiving treatment with BREYANZI. The adverse event of 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. Monitor lifelong for secondary malignancies. In the event that a secondary malignancy occurs, contact
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 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, during this initial period.
Adverse Reactions
Serious adverse reactions occurred in
The most common nonlaboratory adverse reactions of any grade (≥
Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide.
ABECMA Indications
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 four or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.
Important Safety Information
BOXED WARNING: CYTOKINE RELEASE SYNDROME, NEUROLOGIC TOXICITIES, HLH/MAS, AND PROLONGED CYTOPENIA
- 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.
- ABECMA is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ABECMA REMS.
Cytokine Release Syndrome (CRS): CRS, including fatal or life-threatening reactions, occurred following treatment with ABECMA. CRS occurred in
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.
Fifty four percent (68/127) of patients received tocilizumab;
Overall rate of CRS was
Monitor patients at least daily for 7 days following ABECMA infusion at the REMS-certified healthcare facility for signs and symptoms of CRS. Monitor patients for signs or symptoms of CRS for at least 4 weeks after infusion. At the first sign of CRS, institute treatment with supportive care, tocilizumab and/or corticosteroids as indicated.
Counsel patients to seek immediate medical attention should signs or symptoms of CRS occur at any time.
Neurologic Toxicities: 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. CAR T cell-associated neurotoxicity occurred in
Monitor patients at least daily for 7 days following ABECMA infusion at the REMS-certified healthcare facility for signs and symptoms of neurologic toxicities. Rule out other causes of neurologic symptoms. Monitor patients for signs or symptoms of neurologic toxicities for at least 4 weeks after infusion and treat promptly. Neurologic toxicity should be managed with supportive care and/or corticosteroids as needed.
Counsel patients to seek immediate medical attention should signs or symptoms of neurologic toxicity occur at any time.
Hemophagocytic Lymphohistiocytosis (HLH)/Macrophage Activation Syndrome (MAS): HLH/MAS occurred in
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 availableat www.AbecmaREMS.com or 18884235436.
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. Infections (all grades) occurred in
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.
Prolonged Cytopenias: Patients may exhibit prolonged cytopenias following lymphodepleting chemotherapy and ABECMA infusion. In the KarMMa study,
Three patients underwent stem cell therapy for hematopoietic reconstitution due to prolonged cytopenia. Two of the three patients died from complications of prolonged cytopenia. Monitor blood counts prior to and after ABECMA infusion. Manage cytopenia with myeloid growth factor and blood product transfusion support according to institutional guidelines.
Hypogammaglobulinemia: Plasma cell aplasia and hypogammaglobulinemia can occur in patients receiving treatment with ABECMA. Hypogammaglobulinemia was reported as an adverse event in
Monitor immunoglobulin levels after treatment with ABECMA and administer IVIG for IgG <400 mg/dl. Manage per local institutional guidelines, including infection precautions and antibiotic or antiviral prophylaxis.
The safety of immunization with live viral vaccines during or following 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. Monitor life-long for secondary malignancies. If a secondary malignancy occurs, contact
Effects on Ability to Drive and
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.
ONUREG
ONUREG® (azacitidine tablets) is approved in the
CONTRAINDICATIONS
- ONUREG is contraindicated in patients with known severe hypersensitivity to azacitidine or its components.
WARNINGS AND PRECAUTIONS
- Risks of Substitution with Other Azacitidine Products: Due to substantial differences in the pharmacokinetic parameters, the recommended dose and schedule for ONUREG are different from those for the intravenous or subcutaneous azacitidine products. Treatment of patients using intravenous or subcutaneous azacitidine at the recommended dosage of ONUREG may result in a fatal adverse reaction. Treatment with ONUREG at the doses recommended for intravenous or subcutaneous azacitidine may not be effective. Do not substitute ONUREG for intravenous or subcutaneous azacitidine.
-
Myelosuppression: New or worsening Grade 3 or 4 neutropenia and thrombocytopenia occurred in
49% and22% of patients who received ONUREG. Febrile neutropenia occurred in12% . A dose reduction was required for7% and2% of patients due to neutropenia and thrombocytopenia. Less than1% of patients discontinued ONUREG due to either neutropenia or thrombocytopenia. Monitor complete blood counts and modify the dosage as recommended. Provide standard supportive care, including hematopoietic growth factors, if myelosuppression occurs. - Increased Early Mortality in Patients with Myelodysplastic Syndromes (MDS): In AZA-MDS-003, 216 patients with red blood cell transfusion-dependent anemia and thrombocytopenia due to MDS were randomized to ONUREG or placebo. 107 received a median of 5 cycles of ONUREG 300 mg daily for 21 days of a 28-day cycle. Enrollment was discontinued early due to a higher incidence of early fatal and/or serious adverse reactions in the ONUREG arm compared with placebo. The most frequent fatal adverse reaction was sepsis. Safety and effectiveness of ONUREG for MDS have not been established. Treatment of MDS with ONUREG is not recommended outside of controlled trials.
- Embryo-Fetal Toxicity: ONUREG can cause fetal harm when administered to a pregnant woman. Azacitidine caused fetal death and anomalies in pregnant rats via a single intraperitoneal dose less than the recommended human daily dose of oral azacitidine on a mg/m2 basis. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with ONUREG and for at least 6 months after the last dose. Advise males with female partners of reproductive potential to use effective contraception during treatment with ONUREG and for at least 3 months after the last dose.
ADVERSE REACTIONS
-
Serious adverse reactions occurred in
15% of patients who received ONUREG. Serious adverse reactions in ≥2% included pneumonia (8% ) and febrile neutropenia (7% ). One fatal adverse reaction (sepsis) occurred in a patient who received ONUREG. -
Most common (≥
10% ) adverse reactions with ONUREG vs placebo were nausea (65% ,24% ), vomiting (60% ,10% ), diarrhea (50% ,21% ), fatigue/asthenia (44% ,25% ), constipation (39% ,24% ), pneumonia (27% ,17% ), abdominal pain (22% ,13% ), arthralgia (14% ,10% ), decreased appetite (13% ,6% ), febrile neutropenia (12% ,8% ), dizziness (11% ,9% ), pain in extremity (11% ,5% ).
LACTATION
- There are no data regarding the presence of azacitidine in human milk or the effects on the breastfed child or milk production. Because of the potential for serious adverse reactions in the breastfed child, advise women not to breastfeed during treatment with ONUREG and for 1 week after the last dose
REBLOZYL Indication
REBLOZYL is indicated for the treatment of anemia in adult patients with beta thalassemia who require regular red blood cell (RBC) transfusions
REBLOZYL is indicated for the treatment of anemia failing an erythropoiesis stimulating agent and requiring 2 or more red blood cell units over 8 weeks in adult patients with very low- to intermediate-risk myelodysplastic syndromes with ring sideroblasts (MDS-RS) or with myelodysplastic/ myeloproliferative neoplasm with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T)
REBLOZYL is not indicated for use as a substitute for RBC transfusions in patients who require immediate correction of anemia
Important Safety Information
WARNINGS AND PRECAUTIONS
Thrombosis/Thromboembolism
In adult patients with beta thalassemia, thromboembolic events (TEE) were reported in 8/223 (
Hypertension
Hypertension was reported in
Embryo-Fetal Toxicity
REBLOZYL may cause fetal harm when administered to a pregnant woman. REBLOZYL caused increased post-implantation loss, decreased litter size, and an increased incidence of skeletal variations in pregnant rat and rabbit studies. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment and for at least 3 months after the final dose.
ADVERSE REACTIONS
Beta-Thalassemia
-
Serious adverse reactions occurred in
3.6% of patients on REBLOZYL. Serious adverse reactions occurring in1% of patients included cerebrovascular accident and deep vein thrombosis. A fatal adverse reaction occurred in 1 patient treated with REBLOZYL who died due to an unconfirmed case of acute myeloid leukemia (AML)
-
Most common adverse reactions (at least
10% for REBLOZYL and1% more than placebo) were headache (26% vs24% ), bone pain (20% vs8% ), arthralgia (19% vs12% ), fatigue (14% vs13% ), cough (14% vs11% ), abdominal pain (14% vs12% ), diarrhea (12% vs10% ) and dizziness (11% vs5% )
Myelodysplastic Syndromes
-
Grade >3 (≥
2% ) adverse reactions included fatigue, hypertension, syncope and musculoskeletal pain. A fatal adverse reaction occurred in 5 (2.1% ) patients -
The most common (≥
10% ) adverse reactions included fatigue, musculoskeletal pain, dizziness, diarrhea, nausea, hypersensitivity reactions, hypertension, headache, upper respiratory tract infection, bronchitis, and urinary tract infection
LACTATION
It is not known whether REBLOZYL is excreted into human milk or absorbed systemically after ingestion by a nursing infant. REBLOZYL was detected in milk of lactating rats. When a drug is present in animal milk, it is likely that the drug will be present in human milk. Because many drugs are excreted in human milk, and because of the unknown effects of REBLOZYL in infants, a decision should be made whether to discontinue nursing or to discontinue treatment. Because of the potential for serious adverse reactions in the breastfed child, breastfeeding is not recommended during treatment and for 3 months after the last dose.
Please see full Prescribing Information for REBLOZYL.
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