CAR T-cell therapy shows significant progress towards a cure for multiple myeloma.
Ninety-four percent of patients with multiple myeloma achieved clinical remission after receiving chimeric antigen receptor (CAR) T-cell therapy that targeted B-cell maturation protein (BMCA).
Although prior studies show that CAR T-cell therapy targeting CD19 is effective for acute lymphoblastic leukemia (ALL) and some types of lymphoma, success is limited using these therapies in other cancer types.
Recent findings from an ongoing phase 1 clinical trial in China of 35 patients with relapsed or refractory multiple myeloma showed that treatment efficacy emerged as early as 10 days after initial injection of CAR T cells.
Overall, the results showed that the objective response rate was 100% and that 33 of 35 patients (94%) had a complete response or very good partial response within the first 3 months of receiving treatment.
“Although recent advances in chemotherapy have prolonged life expectancy in multiple myeloma, this cancer remains incurable,” said author Wanhong Zhao, MD, PhD. “It appears that with this novel immunotherapy there may be a chance for a cure in multiple myeloma, but we will need to follow patients much longer to confirm that.”
To date, the investigators have followed 19 patients for more than 4 months. Of the 19 patients, 14 have achieved stringent complete response (sCR) criteria, 1 patient achieved partial response, and 4 achieved very good partial remission (VgPR) criteria in efficacy.
Although cytokine release syndrome (CRS) occurred in 85% of patients, it was only temporary. CRS is a common and potentially dangerous adverse event (AE) associated with CAR T-cell therapy. Overall, the symptoms were mild and manageable in most of the patients.
CRS associated symptoms include fever, low blood pressure, difficulty breathing, and problems with multiple organs. Only 2 patients experienced grade 3 CRS, but recovered after receiving tocilizumab (Actemra). There were no neurological AEs reported.
The findings were presented at the 2017 American Society of Clinical Oncology annual meeting in Chicago.
The investigators aim to enroll 100 patients total in this clinical trial, at 4 participating hospitals in China.
“In early 2018, we also plan to launch a similar clinical trial in the United States,” Dr Zhao said. “Looking ahead, we would also like to explore whether BCMA CAR T-cell therapy benefits patients who are newly diagnosed with multiple myeloma.”