Dual-Target CAR T-Cell Therapy in Resistant Multiple Myeloma
Posted: Friday, January 24, 2020
Researchers created a dual-target BM38 chimeric antigen receptor (CAR) T-cell therapy incorporating anti-CD38 and anti–B-cell maturation antigen single-chain variable fragment in tandem plus 4-1BB signaling and CD3 zeta domains. This BM38 CAR T-cell therapy showed improved efficacy and a high overall response rate, according to Heng Mei, MD, PhD, of Huazhong University of Science and Technology in China, who presented the study on behalf of colleagues at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 930).
A total of 16 patients with relapsed or refractory multiple myeloma who had received at least 2 prior treatment regimens were enrolled in this study. Patients were given a lymphodepleting regimen with cyclophosphamide and fludarabine prior to the CAR T-cell infusion. The median follow-up was 36 weeks.
A total of 14 patients achieved an overall response, with 8 achieving a stringent complete response, 2 achieving a very good partial response, and 4 achieving a partial response. There were 14 patients who reached bone marrow residual disease–negative status. The longest duration of stringent complete response was more than 51 weeks, and five of eight patients still maintain this response. The progression-free survival at 9 months was 75%. The BM38 CAR T-cells still exist in patients’ peripheral blood as detected by flow cytometry and quantitative polymerase chain reaction.
At the time of data presentation, no patients experienced dose-limiting toxicities, and no patients had grade 3 or higher neurologic toxicities. Additionally, 10 of the patients (62.5%) experienced cytokine-release syndrome, which was mostly grade 1 or 2. Four patients had grade 3 or higher cytokine-release syndrome, which was resolved with tocilizumab and supportive treatment. For nearly all patients who had a hematologic toxicity, it resolved within the first month.
Disclosures: The authors reported no conflicts of interest.
