Video

Dr. Kumar on Integrating CAR T-Cell Therapy Into Heavily Pretreated Multiple Myeloma

Shaji K. Kumar, MD, discusses the integration of CAR T-cell therapy into the treatment paradigm for heavily pretreated multiple myeloma.

Shaji K. Kumar, MD, a consultant in the Division of Hematology and a professor of medicine with Mayo Clinic, discusses the integration of CAR T-cell therapy into the treatment paradigm for heavily pretreated multiple myeloma.

On March 26, 2021, the FDA approved idecabtagene vicleucel (ide-cel; Abecma) as the first BCMA-directed CAR T-cell therapy for patients with relapsed/refractory multiple myeloma who progressed on 4 or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and a CD38-directed monoclonal antibody.

For now, ide-cel will likely be reserved as an option for patients with triple-class refractory disease, says Kumar. As such, ide-cel is competing against other FDA-approved agents, such as belantamab mafodotin-blmf (Blenrep), selinexor (Xpovio), and melphalan flufenamide (melflufen; Pepaxto), Kumar explains.

Notably, if given the option, many providers would select CAR T-cell therapy over belantamab mafodotin, selinexor, or melflufen because ide-cel demonstrated a high rate of durable responses in patients with heavily pretreated multiple myeloma, Kumar says. However, like the lymphoma paradigm, the reimbursement protocol for ide-cel will not be fully realized for 1 to 3 more years, which limits the treatment’s utility, concludes Kumar.

Related Videos
Mark Awad, MD, PhD, chief, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center
Rasha Cosman, BSc, MBBS, FRACP
Saad Z. Usmani, MD, MBA, FACP, FASCO
Nicholas P. McAndrew, MD, MSCE
Xichun Hu, MD, PhD
Nicolas Girard, MD
Binod Dhakal, MD
Jill Corre, PharmD, PhD
Saad Z. Usmani, MD, MBA, FACP, FASCO
Ashraf Z. Badros, MBCHB