What Abecma does Carvykti might do better

Sales of Carvykti might have stalled, but Johnson & Johnson and Legend now have data that might expand the Car-T therapy’s reach in multiple myeloma. This is thanks to the Cartitude-4 study, which Legend today toplined as positive for its primary endpoint of progression-free survival. While Carvykti and Bristol Myers Squibb/2seventy Bio’s Abecma are both approved for fifth-line or later multiple myeloma, Cartitude-4 tested the earlier setting of second to fourth-line disease. Depending on the full numbers, Cartitude-4 could enable Carvykti to get ahead of Abecma, which last year scored in its own earlier-line trial, Karmma-3, a study that tested a slightly later setting, with patients additionally having to have failed Darzalex. Yet to be revealed is Cartitude-4’s absolute benefit, toxicities, how Carvykti did against each of the two choices of control, and whether the therapy helps patients live longer. Cowen analysts expect Cartitude-4 to have been 90% powered to show a 50% reduction in risk of progression at this interim analysis, and expect 11 months’ mPFS for control. Carvykti sold $55m in the fourth quarter, flat versus three months earlier and short of $60m+ consensus, as a shortage of lentivirus continued to bite.