CAR T-Cell Therapy Appears Promising for Heavily Pretreated Multiple Myeloma

Natalie S. Callander, MD, professor, Hematology/Oncology, Wisconsin Institute Medical Research, University of Wisconsin, discusses the role of chimeric antigen receptor (CAR) T-cell therapy as treatment of patients with multiple myeloma.

There are several different CAR T constructs in development now for the treatment of patients with multiple myeloma, says Callander. Most of these products target BCMA, but there are other myeloma protein targets under evaluation as well.

This therapy looks most promising for the treatment of patients who are out of options for their myeloma. The largest series of data came from the phase 2 KarMMa study, which evaluated the CAR T-cell therapy BB2121. The study induced an 85% response rate in a heavily pretreated population of patients. The phase 1B/2 CARTITUDE-1 study also demonstrated a 100% response rate with CAR T-cell therapy in a smaller subset of patients.

Overall, the use of CAR T cells appears promising, but bring forward some unanswered questions in the field that should be addressed, such as what the role of this cellular therapy is in patients after first or second relapse, or if a maintenance therapy or intervention after completing CAR T-cell therapy could improve outcomes and reduce the risk of relapse in patients. Callander says she expects to see an approval soon for CAR T cells in this space.