Can Myeloma CAR-T Cell Therapy Achieve Cure?

Can Myeloma CAR-T Cell Therapy Achieve Cure?

Multiple Myeloma (MM) is a monoclonal plasma cell malignant proliferative tumor, accounting for approximately 10% of hematological malignancies. Cytogenetic characteristics reflect the biological properties of myeloma cells and are a key factor influencing the prognosis of MM. Common high-risk cytogenetic abnormalities include 1q21 amplification, p53 deletion, t(4,14), and t(11,14) mutations. Approximately 30-50% of MM patients have high-risk cytogenetic abnormalities. Patients with high-risk cytogenetic abnormalities have a progression-free survival (PFS) of only 17 months after first-line treatment, and PFS becomes shorter with increasing lines of therapy. Despite the widespread use of novel targeted therapies and autologous hematopoietic stem cell transplantation, which significantly improves the clinical efficacy in these high-risk patients, the overall prognosis has not been significantly improved.

CAR-T cell therapy has emerged as a novel immunocellular therapy in recent years. BCMA-targeted CAR-T cell therapy has become a standard treatment for relapsed/refractory MM, with some patients achieving the possibility of “clinical cure.”

BCMA Gene and Protein

How effective is CAR-T therapy for high-risk MM patients?

In previous 6 BCMA-CAR-T studies that evaluated the impact of high-risk cytogenetic abnormalities on the efficacy of CAR-T therapy, the overall response rate (ORR) and complete remission rate (CRR) showed no significant differences between the two groups. There was no significant difference in PFS between the high-risk group (38 patients) and the low-risk group (39 patients). These results suggest that anti-BCMA CAR-T therapy may improve the prognosis of MM patients with high-risk cytogenetic features. Furthermore, patients are likely to benefit from early use of CAR-T therapy, and based on existing data, humanized CAR-T cells appear to have clear advantages.

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