CAR T‐Cell Therapy for Multiple Myeloma: A Clinical Practice‐Oriented Review

Abstract

The emergence of chimeric antigen receptor (CAR) T‐cell therapy has revolutionized the treatment of hematologic malignancies, including multiple myeloma (MM). Two B‐cell maturation antigen (BCMA)‐directed CAR T‐cell products — idecabtagene vicleucel (ide‐cel) and ciltacabtagene autoleucel (cilta‐cel) — have received Food and Drug Administration (FDA) approval for patients with relapsed/refractory MM who underwent four or more prior lines of therapy (including an immunomodulatory agent, a proteasome inhibitor, and an anti‐CD38 monoclonal antibody). Despite producing unprecedented response rates in an otherwise difficult to treat patient population, CAR T‐cell therapies are commonly associated with immune‐related adverse events (e.g., cytokine release syndrome and neurotoxicity), cytopenias and infections. Moreover, many patients continue to exhibit relapse post‐treatment, with resistance mechanisms yet to be fully understood. Ongoing basic, translational, and clinical research efforts are poised to generate deeper insights into the optimal utilization of these therapies, improve their efficacy, minimize associated toxicity, and identify new target antigens in MM patients.

Prognostic impact of corticosteroid and tocilizumab use following chimeric antigen receptor T-cell therapy for multiple myeloma

“…Our results affirm the strategic and judicious use of TCZ and CCS for treating immune-mediated toxicities in patients receiving CAR T-cell therapy for MM. Such insights gain additional significance as initiatives are in progress to expand the application of CAR T-cell therapy to earlier stages of MM treatment and across more diverse healthcare settings, underscoring the need for refined supportive strategies in broader clinical contexts [ 41 – 43 ].…”

GZ17-6.02 interacts with proteasome inhibitors to kill multiple myeloma cells

“…More recently, the myeloma therapeutics field has been dramatically altered by the use of CAR-T cells and other immunotherapeutics. [7][8][9][10]. Two CAR-T cells products, directed against the Anti-B-cell maturation antigen (BCMA), idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), have recently received FDA approval for relapsed/refractory MM in patients who had already underwent four or more prior lines of therapy.…”