The Impact of CAR T-Cell Therapy on Hematological Malignancies

Based on that data, CAR T-cell therapy was subsequently studied in earlier lines in lymphoma, and now at least 2 products are approved in the second-line setting and some are under investigation for the first-line setting.3,4 In multiple myeloma, we have 2 approved products targeting BCMA.5 These BCMA CARs can yield high response rates, reaching more than 80% in patients who have failed at least 3 prior lines of therapy, but the durability of the remissions is not as good as in lymphoma patients.6 Whether CAR T-cell therapy could generate more durable responses in earlier lines of multiple myeloma is currently being investigated in ongoing clinical trials. CD19-targeted CAR T-cell therapy can attain a high initial response rate and about half the patients are able to maintain the remission long term, again, after a single infusion.9 Q: ICANS is most commonly seen with the CD19 CARs in leukemia and lymphoma and is less common in patients with multiple myeloma.3,10,11 ICANS is more challenging to manage because the pathophysiology is not as well understood and treatments have a lower response rate compared with CRS. [...]we hope off-the-shelf CAR T cells will drive down the cost since it requires fewer steps in manufacturing and can be made in mass production, similar to antibodies and antibody-drug conjugates.