Recent Approvals of CAR T-Cell Therapy in R/R Multiple Myeloma

Opinion
Video

Following the recent approvals of ide-cel and cilta-cel CAR T-cell therapy for patients with relapsed/refractory multiple myeloma, a hematologist-oncologist discusses clinical research supporting their utilization.

Case: A 60-Year-Old Woman with Later Relapsed/Refractory Multiple Myeloma

Clinical Presentation:

  • A 60-year-old woman who was previously diagnosed 3 years ago with R-ISS stage 2/R2-ISS stage III IgG-lambda multiple myeloma presents to his oncologist after two prior treatment regimens.
    • Lives in a rural community

Prior Treatments:

  • Patient received previous treatments with:
    • D-VRd followed by ASCT with lenalidomide maintenance.
    • Elo-Pd

Follow up and Clinical Workup at Relapse:

  • Ca 12.5 mg/dL; SCr 2.5 mg/dL
  • Hgb 8.2 g/dL; LDH 290 U/L; Albumin 2.8 g/dL
  • Beta-2 microglobulin: 6 mg/dL
  • BM Biopsy: 65% lambda light chain restricted.
  • sIFE, IgG lambda present
  • M protein 5.2 g/dL; sFLC kappa 5 mg/dL; sFLC lambda 560 mg/dL
  • Lambda/Kappa ratio, 112
  • Repeat Imaging:
    • PET/CT scan showed no additional lesions.
  • ECOG PS 1
  • After discussion with his clinical team, the patient begins evaluations for CAR T referral.
    • Patient ultimately proceeded to ide-cel CAR T-cell infusuion.
      • Achieved stringent CR at day 30.

Video content above is prompted by the following question:

  • Following the FDA’s ODAC meetings and recent approvals of CAR T in early relapsed/refractory MM, what ongoing studies may further support the use of CAR T in these patients?
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