Dr Bal on the Evolution of CAR T-cell Therapy in Multiple Myeloma

Susan Bal, MD, assistant professor, Hematology, Medical Oncology, University of Alabama at Birmingham (UAB), UAB Health, discusses the evolution of CAR T-cell therapy in multiple myeloma.

In a presentation at an OncLive® State of the Science Summit™, Bal highlighted key updates across the multiple myeloma treatment landscape, specifically focusing on CAR T-cell therapy. The emergence of CAR T-cell therapy has represented a notable treatment advancement across hematologic malignancies, including multiple myeloma, Bal begins. Currently, there are 2 CAR T-cell therapies approved by the FDA for patients with relapsed/refractory multiple myeloma who have received at least 4 prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody: idecabtagene vicleucel (ide-cel; Abecma) and ciltacabtagene autoleucel (cilta-cel; Carvykti). The phase 2 KarMMA trial (NCT03361748) led to the FDA approval of ide-cel in March 2021, and data from the phase 1b/2 CARTITUDE-1 trial (NCT03548207) supported the FDA approval of cilta-cel in February 2022.

Outcomes from these 2 pivotal trials showed high and durable response rates in heavily pretreated patient populations, Bal continues. Trials exploring ide-cel and cilta-cel in earlier lines of therapy, where patients are generally more fit and have a stronger immune system, could lead to higher response rates, Bal expands.

Ide-cel and cilta-cel are both BCMA-targeted CAR T-cell therapies; however, novel CAR T-cell therapies directed at other targets, such as GPRC5D, are being explored, and these agents could provide additional options for patients with multiple myeloma, particularly those who have experienced disease progression on approved therapies, Bal explains. The exploration of novel targets and the use of CAR T-cell therapy in earlier lines of treatment could stand to improve treatment options for patients with multiple myeloma, Bal concludes.