Novel Immunotherapy for Poor-Prognosis Relapsed Multiple Myeloma
Posted: Friday, June 29, 2018
An innovative treatment of genetically modifying T cells to express B-cell maturation antigen targeting chimeric antigens demonstrated “substantial” activity against relapsed or refractory multiple myeloma, according to a study by James N. Kochenderfer, MD, of the National Institutes of Health, and colleagues published in the Journal of Clinical Oncology.
The highest dosage of chimeric antigen receptor (CAR)–B-cell maturation antigen (BCMA) T-cell infusions (9 x 106 CAR-BCMA T cells/kg) was given to 16 patients. Patients had a median of nearly 10 lines of therapy before protocol enrollment, and nearly two-thirds of patients had refractory multiple myeloma.
The overall response rate for this group was 81%, with 63% of patients experiencing a very good partial or complete response. All 11 patients who had a partial response or better and who had disease that was evaluable for minimal residual disease obtained bone marrow minimal residual disease–negative status.
The median event-free survival was 31 weeks. Anti–multiple myeloma responses seemed to be linked to high peak blood CAR-positive cell levels. All but one patient had a decrease in their serum multiple myeloma marker. Cytokine-release syndrome toxicities were severe but reversible. Vasopressor support for hypotension was required for six patients, and one required mechanical ventilation.
According to the researchers, “Anti-BCMA CAR T cells are a novel and powerful therapy for [multiple myeloma], with many promising avenues for improvement.”