Quiz: The Role of CAR T Cells in Multiple Myeloma

1.  Preliminary clinical findings suggest CAR T cells may be more effective against multiple myeloma if they are manufactured from patients before they experience relapsed or refractory disease.

A. True

B.False

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Answer: A. True. Recently reported findings from a phase I clinical cohort study of 38 patients with multiple myeloma found that post-induction manufactured CAR T cells exhibit higher proportions of biomarker immunophenotypes that have been shown to be associated with clinical response.

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2. Development of anti-B-cell maturation antigen CAR T-cell therapy (BCMA CART) for multiple myeloma has built on earlier findings among patients with chronic lymphocytic leukemia (CLL), including the finding that which of the following at the time of leukapheresis is/are associated with clinical response?

A.Lower frequency of CD8+/CD45RO-/CD27+ T cells

B. Higher CD4/CD8 ratio

C. Lower frequency of CD8+ T cell

D.All of the above

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Answer: B. Higher CD4/CD8 ratio. Among patients undergoing CAR T-cell therapy for CLL, a higher frequency of CD8+/CD45RO-/CD27+ T cell immunophenotype and higher CD4/CD8 ratio at the time of leukapheresis were associated with clinical response.

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3.  Chimeric antigen receptor (CAR) T-cell therapies against multiple myeloma include which of the following targets?

A.B-cell maturation antigen (BCMA)

B.CD19

C.CD138

D.All of the above

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Answer: D. All of the above. CAR T-cell therapies against multiple myeloma that target several antigens are under clinical development, including strategies that target CD19, CD138 and BCMA. A recent single-arm phase 2 trial showed that anti-CD19 and anti-BCMA combination CAR T-cell therapy is feasible in patients with relapsed/refractory multiple myeloma.

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4.  Among heavily pretreated patients with relapsed/refractory multiple myeloma in phase I clinical trials, BCMA CAR T-cell therapy has yielded up to ___% overall response rates.

A.60

B.70

C.80

D.90

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Answer: D. 90%. At higher cell doses, BCMA CAR T-cell therapy has achieved 64%-90% overall response rates among patients with relapsed/refractory multiple myeloma who had received up to 8 previous lines of therapy.

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5.  ___% of patients with relapsed/refractory multiple myeloma achieved complete response (CR) with combination anti-CD19 and BCMA CAR T-cell therapy in a recent phase 2 clinical trial.

A.27

B.37

C.47

D. 57

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Answer: D. 57%. Fifty-seven percent of patients in a small (n=21) phase 2 clinical trial experienced CR. Eighty-one percent of patients had ongoing responses at 6-month median follow-up.