Significant Progress in CAR T-Cell Therapy for Difficult-to-Treat Hematologic Malignancies

Abstract

The latest clinical and real-world evidence of chimeric antigen receptor (CAR) T-cell therapy continues to challenge standard treatment paradigms for many hematologic malignancies with limited treatment options. In particular, recently approved CAR T-cell therapies are forging a path towards improving patient outcomes and health-related quality of life (HRQoL) in difficultto-treat relapsed/refractory (R/R) blood cancers such as diffuse large B-cell lymphoma (DLBCL), multiple myeloma (MM), mantle cell lymphoma (MCL) and B-cell acute lymphoblastic leukemia (B-ALL). Here the latest data on commercially available CAR T-cell therapies are summarized and discussed.

The Gaining Momentum of BCMA-Directed Therapies for Relapsed/Refractory Multiple Myeloma

“…Notably, neurotoxicity signals reported with cilta-cel were different from other CAR T-cell therapies and were discussed in detail by Arber et al (2022) in the healthbook TIMES Oncology Hematology. 10,27 Briefly, 17% (any grade) and 2% (grade 3 or 4) of patients experienced ICANS but a novel type of neurotoxicity was also observed. 27 A total of 5% of patients experienced a cluster of ciltacel-related movement and neurocognitive treatment-related adverse events (MNT).…”

“…7 Over the past few years, a new generation of immunotherapies has emerged, including drugs directed against BCMA, a novel treatment target for MM due to its highly selective expression in malignant plasma cells. 8,9 To date, encouraging results were reported for BCMA-directed CAR T-cell therapies 10 like idecabtagene vicleucel 11 and ciltacabtagene autoleucel, 12 belantamab mafodotin, 13 an antibody-drug conjugate (ADC), and bispecific antibodies such as teclistamab and elranatamab. 14,15…”