New study has discovered therapeutic alternatives for people whose blood cancer relapses following CAR-T therapy

Researchers at Memorial Sloan Kettering Cancer Center (MSK) and Mount Sinai Hospital have discovered medicines that can help patients with multiple myeloma, a kind of blood cancer, who have tried the immunotherapy CAR-T but have had relapses.
CAR-T treatment, which stands for chimeric antigen receptor T-cell therapy, enlists immune cells called T cells to combat multiple myeloma by modifying them in the lab so that they can detect and destroy cancer cells. It has proven a game-changing treatment for this lethal malignancy, yet some patients relapse after getting CAR-T therapy and have no other alternatives.

The researchers analysed a large sample of multiple myeloma patients who relapsed after receiving a form of CAR-T cell treatment termed BCMA-directed CAR-T in a new study published in the journal Blood in November. In order to combat multiple myeloma, this form of CAR-T cell therapy targets the BCMA protein on malignant plasma cells.
Other treatments that engage T cells, such as bispecific antibodies and other forms of CAR-T cell therapy, tend to have the most significant effectiveness in bringing down these relapsed individuals’ malignancy for the longest period of time, according to the researchers.

“The findings of this study will serve as a benchmark for future prospective clinical studies that intend to improve the outcomes of patients who progress after CAR-T,” said Samir Parekh, MD, Director of Translational Research in Multiple Myeloma and co-leader of The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai. “This is the first research to report on the results of various treatment alternatives administered to a large cohort of patients who relapsed after receiving anti-BCMA CAR-T therapy. This is one of the most pressing and unmet demands in myeloma patients, and it piques the haematology community’s interest.”

The clinical features of 79 patients, the medications administered after recurrence, and the patients’ reactions to the therapies were all examined in this retrospective analysis. To far, the median overall survival for patients is around 18 months.
Stem cell transplantation were also effective in these individuals. Other medication combinations can also be employed with varying success depending on the features of each patient’s malignancy, according to the research.
The patients were treated at MSK and The Tisch Cancer Institute.
“We are excited that subsequent use of additional innovative immune treatments, such as a second CAR-T cell therapy or a bispecific antibody, was possible and resulted in sustained responses in patients,” said Sham Mailankody, MBBS, MSK Associate Attending Physician and senior author on the research.

“We are excited to continue this research and realise the full potential of immune treatments for patients with multiple myeloma.”