Summary: CAR T-cell therapy is an exciting second-line option for patients living with relapsed multiple myeloma. In this presentation, Dr. Ahmed reviews each step in the CAR T process and discusses a number of studies that support its use. Potential side effects are reviewed, and exciting future trends are discussed.
Presenter: Nausheen Ahmed MD, The University of Kansas Cancer Center
To read the transcript, go to:
bmtinfonet.org/video/car-t-ce...
Highlights:
(02:37): CAR T therapy is approved for patients with relapsed or refractory myeloma. It recently moved from fourth-line therapy to second-line therapy, meaning patients may be offered this therapy earlier in their disease course.
(04:41): B-cell Maturation Antigen (BCMA) is expressed on plasma cells and is a target in myeloma. Abecma (idecabtagene vicleucel or Ide-cel) and Carvykti or Cilta-cel are both FDA-approved, BCMA-targeted CAR T therapies for myeloma.
(07:44): Insurance coverage, fitness, comorbidities and disease characteristics are factors to consider when deciding which CAR T product best fits each patient.
(08:27): T-cells are collected by a process called leukapheresis. The collected T-cells then go to a lab and are genetically modified. While this is being done, patients often receive bridging therapy until their T-cells are ready.
(11:10): The CAR T pre-evaluation includes scans, labs, a bone marrow biopsy, an echocardiogram, cognitive and neurological exams, and a social support evaluation.
(19:33): Disease characteristics such as high-risk cytogenetics, extramedullary disease, high disease burden, and high-stage disease may be factors that affect outcomes with CAR T-cell therapy.
(20:35): Patient characteristics such as performance status, age, comorbidities, and frailty may also affect outcomes of CAR T-cell therapy.
(37:21): Despite potential significant and serious side effects, the most common cause of death in patients who receive CAR T-cell therapy for myeloma remains the disease itself.
(38:15): The future of CAR T-cell therapy includes new targets such as GPRC5D. Studies are in progress to explore allogeneic CAR T-cell therapy, which involves using someone else's genetically modified T-cells to combat your myeloma.
(42:14): Disparity in accessing CAR T-cell therapy presents challenges, with geographical location, socioeconomic status and insurance playing significant roles.
April 2024, Part of the Virtual Celebrating a Second Chance at Life Survivorship Symposium 2024
Presentation is 40 minutes long with 19 minutes of Q & A.
Key Points:
Studies have shown that patients treated with CAR T-cell therapy experience improved overall response rates, progression-free survival, and overall survival.
Potential side effects of CAR T-cell therapy include cytokine release syndrome (CRS), Immune effector cell-associated neurotoxicity syndrome (ICANS), movement disorders, low blood counts, increased risk of infections, and secondary malignancies.
Patients who receive CAR T-cell therapy are required to adhere to strict monitoring guidelines, which include staying close to the treating facility for at least 2 weeks, refraining from driving for 8 weeks, and having a caregiver at home to assist with monitoring for side effects.
Meet the speaker:
www.kumc.edu/nahmed5.html
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8 май 2024
