Is Immunotherapy Safe for Patients With Myeloma and HBV Infection?
Posted: Tuesday, January 12, 2021
For patients with refractory or relapsed multiple myeloma who also have chronic or resolved hepatitis B virus (HBV) infection, therapy with B-cell maturation chimeric antigen receptor (BCMA CAR) T cells may prove to be an effective therapy, according to an article published in the Journal for ImmunoTherapy of Cancer. Coadministration of antiretroviral therapy for concomitant HBV infection did not appear to impact BCMA CAR T-cell therapy's efficacy, explained Quanli Gao, MD, of the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, China, and colleagues.
In this small study, nine patients with refractory or relapsed multiple myeloma with chronic or resolved HBV infection were recruited. All patients received BCMA CAR T-cell therapy via infusion. Serum was collected from the patients and analyzed to determine hepatitis B expression.
The study authors reported an objective response rate of 100%, and a progression-free survival rate of 88.9% at 12 months. One patient was positive for the hepatitis B surface antigen; however, no reactivation of the virus was observed 9.8 months after administering anti–hepatitis B virus, before and after BCMA CAR T-cell therapy. Of the remaining eight patients who previously had HBV infection, two were given anti–hepatitis B pharmacotherapy. Both of these patients did not demonstrate reactivation of their HBV infection. Moreover, of the six patients who did not receive prophylactic therapy, five had a reactivation of their HBV infection, and one patient was positive for the hepatitis B surface antigen.
“Strictly monitoring the hepatitis B infection and concurrently administering antiviral therapy are recommended to prevent the reactivation of hepatitis B,” explained Dr. Gao and colleagues.
Disclosure: For full disclosures of the study authors, visit jitc.bmj.com.