In March 2021, the FDA approved idecabtagene vicleucel, a chimeric antigen receptor T-cell therapy targeting the B-cell maturation antigen (BCMA), for adult patients with relapsed/refractory multiple myeloma (RRMM) after ≥4 lines of therapy including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 mAb. Approval was based on overall response rate (ORR), complete response (CR) rate, and duration of response (DOR) in 100 adult patients with RRMM treated with idecabtagene vicleucel in a single-arm trial. Patients received a single infusion of idecabtagene vicleucel, preceded by lymphodepleting chemotherapy with cyclophosphamide and fludarabine. Of the 100 patients in the efficacy evaluable population, ORR was 72% [95% confidence interval (CI), 62–81] with stringent CR rate of 28% (95% CI, 19–38). After median follow-up of 10.7 months, median DOR was 11 months (95% CI, 10.3–11.4) in responders (partial response or better) and 19 months [95% CI, 11.4 months, not estimable (NE)] in patients who achieved stringent CR. Serious adverse reactions occurred in 67% of 127 patients evaluated for safety. Grade 3 or higher cytokine release syndrome and neurologic toxicities occurred in 9% and 4%, respectively, leading to a Risk Evaluation and Mitigation Strategy. Hemophagocytic lymphohistiocytosis/macrophage activation syndrome occurred in 4%, with two fatalities. Prolonged cytopenia requiring hematopoietic rescue occurred in 2% (3/127), with two fatalities.
Alzheimer’s disease (AD) is the most prevalent and severe neurodegenerative disease affecting
more than 0.024 billion people globally, more common in women as compared to men. Senile
plaques and amyloid deposition are among the main causes of AD. Amyloid deposition is considered as a
central event which induces the link between the production of β amyloid and vascular changes. Presence
of numerous biomarkers such as cerebral amyloid angiopathy, microvascular changes, senile plaques,
changes in white matter, granulovascular degeneration specifies the manifestation of AD while an aggregation
of tau protein is considered as a primary marker of AD. Likewise, microvascular changes, activation
of microglia (immune defense system of CNS), amyloid-beta aggregation, senile plaque and many
more biomarkers are nearly found in all Alzheimer’s patients. It was seen that 70% of Alzheimer’s cases
occur due to genetic factors. It has been reported in various studies that apolipoprotein E(APOE) mainly
APOE4 is one of the major risk factors for the later onset of AD. Several pathological changes also occur
in the white matter which include dilation of the perivascular space, loss of axons, reactive astrocytosis,
oligodendrocytes and failure to drain interstitial fluid. In this review, we aim to highlight the various
biological signatures associated with the AD which may further help in discovering multitargeting drug
therapy.
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