CAR-T cell therapy in Multiple Myeloma: current status and future challenges

The treatment of multiple myeloma has changed dramatically in recent years, with huge strides forward made in the field. Chimeric antigen receptor T-cell therapy targeting the B cell maturation antigen (BCMA) is now widely approved in relapsed refractory patients and is moving into earlier treatment...

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Bibliographic Details
Published in:Blood cancer journal (New York) 2024-11, Vol.14 (1), p.206-16, Article 206
Main Authors: Swan, Dawn, Madduri, Deepu, Hocking, Jay
Format: Article
Language:English
Subjects:
631/67/327
692/699/67/1990/804
Antigens
B-Cell Maturation Antigen - antagonists & inhibitors
B-Cell Maturation Antigen - immunology
Biomedical and Life Sciences
Biomedicine
Cancer Research
Cancer therapies
Cells
Cytokine storm
FDA approval
Hematology
Humans
Immunotherapy, Adoptive - adverse effects
Immunotherapy, Adoptive - methods
Lymphocytes
Monoclonal antibodies
Multiple myeloma
Multiple Myeloma - therapy
Neurotoxicity
Oncology
Receptors, Chimeric Antigen - immunology
Receptors, Chimeric Antigen - therapeutic use
Regulatory approval
Remission (Medicine)
Review
Review Article
Standard of care
T-Lymphocytes - immunology
Transplants & implants
Tumor Microenvironment - immunology
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Description
Summary:The treatment of multiple myeloma has changed dramatically in recent years, with huge strides forward made in the field. Chimeric antigen receptor T-cell therapy targeting the B cell maturation antigen (BCMA) is now widely approved in relapsed refractory patients and is moving into earlier treatment lines. In this review, we discuss the evidence underpinning current regulatory approvals and consider mechanisms through which CAR-T cell efficacy could be improved. These include tackling BCMA-loss, harnessing the immunosuppressive tumour microenvironment, manufacturing concerns including the potential role of other cellular sources, safety issues such as cytokine release syndrome and neurotoxicity, and optimal patient selection.
ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-024-01191-8