Dr. Madduri on Treatment After CAR T Cells in Myeloma

Deepu Madduri, MD, assistant professor, Mount Sinai Hospital, discusses treatment after chimeric antigen receptor (CAR) T-cell therapy in patients with myeloma.

One of the biggest unmet needs in the myeloma treatment landscape is for the patients who need treatment after receiving CAR T cells, Madduri says, although there are strategies emerging in this setting. Most CAR T cell products are BCMA-directed, and BCMA antibody drug conjugates and other targeted therapies have been developed. An important question is whether the already penta-refractory patients who progress on CAR T cells have lost BCMA antigen, and if so, can they be treated with these other options? Research is still underway to better understand the mechanism of BCMA.

However, Madduri says, there is hope that CAR T cells will soon bring curative strategies to the treatment of these patients. Recently, at the 2018 ASH Annual Meeting, the anti-BCMA CAR T cell therapy bb21217 demonstrated an objective response rate of 83.3% with a very good partial response or better rate of 75% in patients with heavily pretreated relapsed/refractory multiple myeloma.