Ravi Vij, MD

Saad Usmani, MD

Ravi Vij, MD, Professor of Medicine at Washington University School of Medicine, St. Louis, and Saad Usmani, MD, Director of Plasma Cell Disorders at Levine Cancer Institute, Charlotte, North Carolina, spoke to The ASCO Post about the studies presented on chimeric antigen receptor (CAR) T-cell therapies in multiple myeloma. They co-moderated an immunotherapy session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.

Both said they were “definitely excited” about the potential for CAR T-cell therapy in multiple myeloma. They also agreed that, of the multiple products, there is no clear front runner, and although data from Chinese studies may look a bit stronger, the study populations are often different from those in U.S. studies.

“In Chinese studies, where you see 100% response rates, remember their populations are usually less heavily pretreated,” Dr. Vij said. “They don’t give patients modern drugs, such as carfilzomib, daratumumab, and pomalidomide. These drugs are very active, and most of our patients on trials have received them, but their patients have not. Although the results may look a little better, you cannot say it’s because of a superior product. All the studies are heterogeneous, and the follow-up is still short.”

Dr. Usmani agreed: “It’s difficult to compare one product to the other, but what you can compare, potentially, is their side-effect profiles. At this time, none is standing out compared with the others, but that could change.”

For example, he said, as compared with the anti-CD19 CAR T-cell products, the BCMA-directed CAR T cells are associated with a lower rate of grade 3 cytokine-release syndrome. “I think the differences in toxicity will be the key to their differences from each other,” Dr. Usmani said. ■

DISCLOSURE: Dr. Vij has received honoraria from or served on advisory boards for Celgene, Bristol-Myers Squibb, Amgen, Jazz Pharmaceuticals, Takeda, Janssen, and Karyopharm and has received research funding from Celgene, Bristol Myers-Squibb, and Takeda. Dr. Usmani has served as a consultant for AbbVie, Amgen, Celgene, Genmab, Merck, Mundipharma, Janssen, and Seattle Genetics and has received research funding from Amgen, Bristol-Myers Squibb, Celgene, Janssen, Merck, Pharmacyclics, Sanofi, Seattle Genetics, and Takeda.