Dr. Shah Discusses Potential of bb21217 in Multiple Myeloma

Nina Shah, MD
Published: Wednesday, Jan 09, 2019



Nina Shah, MD, associate professor of medicine at the University of California, San Francisco Helen Diller Comprehensive Cancer Center, discusses the potential of bb21217 in the treatment of patients with multiple myeloma.

In a study presented at the 2018 ASH Annual Meeting, the anti–BCMA chimeric antigen receptor (CAR) T-cell therapy bb21217 was tested in patients with relapsed/refractory multiple myeloma who were treated with at least 3 prior lines of therapy. Participants had to have been previously exposed to an immunomodulatory agent and a proteasome inhibitor, while expressing at least 50% BCMA in their bone marrow plasma. Shah notes that this is a particularly difficult-to-treat patient population.

The toxicity profile associated with bb21217 was comparable to what it is typically seen with CAR T cells, Shah says. Two-thirds of patients had cytokine release syndrome (CRS), and most of these were grade 1 or 2 events; however 1 patient had a grade 3 event, Shah reports. Three patients had neurotoxicity, 2 of which were grade 1 or 2, but 1 patient had a grade 4 event with encephalopathy in the setting of a grade 3 CRS.

The grade 4 event, explains Shah, required her team to expand the dose level. Another 6 patients ended up receiving treatment at this dose level in order to determine if high versus low tumor burden could contribute to the safety signal. They found that the rest of the patients did not experience any dose-limiting toxicities, so they concluded the grade 4 event to be an isolated one.

Objective response rate was 83.3%, with a very good partial response or better rate of 75% in the 12-patient cohort. The complete remission (CR) or stringent CR rate was 25%, with a minimal residual disease negativity rate of 100% in this group. Greater follow up is needed to understand the full efficacy of the treatment, Shah notes.
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Nina Shah, MD, associate professor of medicine at the University of California, San Francisco Helen Diller Comprehensive Cancer Center, discusses the potential of bb21217 in the treatment of patients with multiple myeloma.

In a study presented at the 2018 ASH Annual Meeting, the anti–BCMA chimeric antigen receptor (CAR) T-cell therapy bb21217 was tested in patients with relapsed/refractory multiple myeloma who were treated with at least 3 prior lines of therapy. Participants had to have been previously exposed to an immunomodulatory agent and a proteasome inhibitor, while expressing at least 50% BCMA in their bone marrow plasma. Shah notes that this is a particularly difficult-to-treat patient population.

The toxicity profile associated with bb21217 was comparable to what it is typically seen with CAR T cells, Shah says. Two-thirds of patients had cytokine release syndrome (CRS), and most of these were grade 1 or 2 events; however 1 patient had a grade 3 event, Shah reports. Three patients had neurotoxicity, 2 of which were grade 1 or 2, but 1 patient had a grade 4 event with encephalopathy in the setting of a grade 3 CRS.

The grade 4 event, explains Shah, required her team to expand the dose level. Another 6 patients ended up receiving treatment at this dose level in order to determine if high versus low tumor burden could contribute to the safety signal. They found that the rest of the patients did not experience any dose-limiting toxicities, so they concluded the grade 4 event to be an isolated one.

Objective response rate was 83.3%, with a very good partial response or better rate of 75% in the 12-patient cohort. The complete remission (CR) or stringent CR rate was 25%, with a minimal residual disease negativity rate of 100% in this group. Greater follow up is needed to understand the full efficacy of the treatment, Shah notes.



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