Dr. Madduri on the Potential Impact of CAR T-Cell Therapy in Multiple Myeloma

Deepu Madduri, MD, assistant professor, medicine, hematology and medical oncology, Mount Sinai Hospital, discusses the potential impact of CAR T-cell therapy in multiple myeloma.

There are several CAR T-cell products that are being explored in myeloma, most of which target BCMA. It’ll be important to wait for the data to come out of these trials because each product would preclude exposure to another in practice, explains Madduri. For example, if a BCMA bispecific monoclonal antibody is given, a bispecific CAR T-cell therapy cannot be given and vice versa. It will also be interesting to see what patients are chosen to participate in these studies, she adds. There is also a lot of ongoing research exploring CAR T-cell resistance, persistence, and relapse.

Every year, more therapies are being approved in myeloma. Most recently, the FDA approved selinexor (Xpovio) for the treatment of penta-refractory patients. Now, the phase I CRB-401 trial (NCT02658929) of bb2121 has completed enrollment. A biologics license application for the agent may be submitted to the FDA early next year, says Madduri.

Moreover, there are going to be commercially available CAR T-cell therapies, which is going to change the treatment paradigm very quickly. However, it remains to be seen whether patients who progress on BCMA bispecific monoclonal antibodies will derive any benefit from CAR T-cell therapy in the real-world setting.