
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.
Selected ph3 trials of anti-BCMA Car-T therapies | |||
---|---|---|---|
Salvage* | Earlier line | Front line | |
Carvykti (Johnson & Johnson/Legend Biotech) | |||
5L+ | 2-4L | 1L (no ASCT) | 1L |
Cartitude-1 | Cartitude-4 | Cartitude-5 | Cartitude-6 |
Single arm | Versus PVd or DPd | Versus Rd (after VRd) | Versus ASCT (after DVRd) |
98% ORR | Positive for PFS | Ends Jun 2026 | Ends Jun 2026 |
Abecma (Bristol Myers Squibb/2seventy Bio) | |||
5L+ | 3-5L | (No ph3 studies) | |
Karmma | Karmma-3 | ||
Single arm | Versus DPd, IRd, Kd or EPd | ||
72% ORR | PFS HR=0.49 | ||
Notes: *approved use; PVd=Pomalyst, Velcade + dexamethasone; DPd=Darzalex, Pomalyst + dexamethasone; VRd=Velcade, Revlimid + dexamethasone; Rd=Revlimid + dexamethasone; DVRd=Darzalex, Velcade, Revlimid + dexamethasone; IRd=Ninlaro, Revlimid + dexamethasone; Kd=Kyprolis + dexamethasone; EPd=Empliciti, Pomalyst + dexamethasone; ASCT=autologous stem cell transplant. Source: prescribing info & clinicaltrials.gov. |