Researchers have identified potential therapies to treat patients with multiple myeloma whose cancer has relapsed following chimeric antigen receptor (CAR) T-cell therapy, according to a novel study published by Van Oekelen et al in Blood.
CAR T-cell therapy has been a revolutionary treatment for multiple myeloma, but some patients relapse following treatment, leaving them with a lack of effective treatment options afterward.
In the new retrospective study, researchers examined the outcomes of 79 patients with multiple myeloma when they were given B-cell maturation antigen (BCMA)-directed CAR T-cell therapy—a treatment designed to target the BCMA protein on cancerous plasma cells.
The researchers found that other therapies that engaged T cells, including bispecific antibodies and other types of CAR T-cell therapies, appeared to have the most pronounced success at limiting multiple myeloma’s progression for the greatest length of time.
“The findings of this study will serve as a benchmark for future prospective clinical studies that intend to improve the outcomes of patients who progress after CAR T-cell therapy,” said senior study author Samir Parekh, MD, MBBS, Professor of Medicine and Oncology Sciences, Director of Translational Research in Myeloma, and Co-Leader of the Cancer Clinical Investigation program at The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai. “This is the first study to report outcomes of different therapeutic options given to a large cohort of patients who relapsed after [anti–BCMA CAR T-cell therapy]. This is one of the most urgent and unmet needs in [patients with] myeloma and, therefore, of great interest to the hematology community,” Dr. Parekh highlighted.
For the study, researchers analyzed the disease characteristics, the treatments given after relapse, and the responses to the therapies of the 79 patients. The median overall survival of the patients who participated in the study was about 18 months to date.
The findings also suggested that stem cell transplants may have some efficacy for these patients. In addition, other drug combinations were shown to have variable efficacy based on the characteristics of the individual patients’ cancer.
“We’re encouraged that subsequent use of other novel immune therapies like a second CAR T-cell therapy or a bispecific antibody was feasible and led to durable responses in patients,” said senior study author Sham Mailankody, MBBS, Associate Attending Physician as well as a medical oncologist and hematologist at Memorial Sloan Kettering Cancer Center. “We look forward to continuing this work and unlocking the full potential of immune therapies for patients with multiple myeloma,” he concluded.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.
