Dr Matous on the Future Directions of CAR T-Cell Therapy in Multiple Myeloma

Jeffrey V. Matous, MD, member physician, Colorado Blood Cancer Institute, clinical professor of medicine, University of Colorado, discusses future directions of CAR T-cell therapy in multiple myeloma, highlighting the potential promise of novel targets beyond BCMA.

BCMA was a target that previously led to the development of several agents across the multiple myeloma treatment landscape, including bispecific antibodies and the CAR T-cell therapies idecabtagene vicleucel (ide-cel; Abecma) and ciltacabtagene autoleucel (cilta-cel; Carvykti), which are both currently approved by the FDA, Matous begins. As more patients have been treated with BCMA-directed agents, there remains a question regarding subsequent treatments for this patient population following disease progression, Matous says.

Although switching from one BCMA-targeted agent to another following progression could be an option, he expands. it may also be a beneficial approach to target a different antigen on the surface of the malignant plasma cells, he says. This is where novel targets such as GPRC5D or FcRH5 come into play, Matous notes. Additionally, novel dual-targeting CAR T-cell therapies directed at CD19 and CD38 are also under development, Matous explains.

Having a variety of agents targeting different antigens is an attractive way to approach patients following disease progression, Matous continues. Additionally, Matous notes that clinicians at the University of Colorado Health Sciences Center have experience at their center treating patients with GPRC5D CAR T-cell therapy approaches after their disease did not responde well to a BCMA-targeted therapy. These approaches have generated excellent results thus far, making it a potential option for patients in this setting, Matous concludes.