Exploring Challenges With CAR T Cells and NK Cells in Multiple Myeloma

C. Ola Landgren, MD, PhD, chief of Myeloma Service and hematologic oncologist at Memorial Sloan Kettering Cancer Center, discusses the use of chimeric antigen receptor (CAR) T cells and CAR natural killer (NK) cells in the multiple myeloma setting.

As with every therapy, there are pros and cons to the use of NK cells and CAR T cells, according to Landgren. One of the challenges when it comes to CAR T cells is the practical delivery of these agents since patients usually need to be hospitalized. These patients also have to undergo procedures if they are being treated with autologous CAR T cells. This therapy implies patients have to come in, go through CAR T-cell harvesting, and then come back about a month later when they can receive these CAR T cells in the hospital.

Landgren says that with allogeneic CAR T cells, there is no need to harvest the cells because they come from donors. That is also true for treatment with NK cells.

There has been investigation into the possibility of making CAR T-cell therapy done as an outpatient treatment, but it depends on management and adverse effects. Some of the CAR T cells have a delayed onset of cytokine release syndrome, so maybe that will be CAR T cells for myeloma that can be done in more of an outpatient setting, but this is to be proven going forward, Landgren explains.

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