What Kind of Multiple Myeloma Patients Are Suitable for CAR-T Therapy in China?

# What Kind of Multiple Myeloma Patients Are Suitable for CAR-T Therapy in China?

Multiple Myeloma

#MultipleMyeloma #CAR_Therapy #MM #CART #RRMM #Hematology

**Multiple Myeloma** (MM) is a malignant hematological disease that affects plasma cells. In recent years, various drugs and treatment methods, such as proteasome inhibitors, immunomodulatory drugs, and autologous stem cell transplantation, have significantly improved the prognosis of multiple myeloma patients. However, a considerable number of patients still experience relapses and refractory disease. For these patients, CAR-T cell therapy is emerging as a groundbreaking and effective treatment option.

China has made remarkable progress in CAR-T therapy technology in recent years, becoming a global leader in the field of hematological diseases. This has attracted patients worldwide to seek this advanced treatment. So, which multiple myeloma patients are suitable to receive CAR-T treatment in China?

## 1. **Indications: Preferred Choice for Drug-Resistant/Relapsed/Refractory Multiple Myeloma Patients**

CAR-T therapy is typically recommended for multiple myeloma patients who have developed resistance to standard treatments (such as proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies) and are in their third line of treatment or beyond. In China, CAR-T therapy has broader indications and better efficacy.

### Suitable Patient Types:

1. Relapsed or refractory multiple myeloma patients, typically those who have undergone at least second-line treatments.

2. Patients with high-risk genetic characteristics, such as certain mutations (e.g., 17p deletion, t(4;14) translocation).

3. Patients unable to tolerate traditional treatments, including chemotherapy, other targeted therapies, stem cell transplantation, or immunomodulatory treatments, due to poor tolerance or severe side effects.

4. Patients who are BCMA-positive.

5. Patients whose disease continues to progress despite other treatments, especially chemotherapy.

6. Patients who are ineligible for stem cell transplantation.

7. Patients with severe symptoms not responsive to conventional treatments, such as bone pain, anemia, hypercalcemia, and kidney damage.

8. High tumor burden patients—experts generally reduce the tumor burden first before administering CAR-T therapy, often through bridging or sequential treatments.

Among the four global CAR-T products targeting the BCMA marker in multiple myeloma, two Chinese products stand out for their efficacy and affordability. The most effective product currently is IASO Bio’s FUCASO (Equecabtagene Autoleucel), with a complete response (CR) rate of 82.4%.

## 2. **Patients in Good Physical Condition**

CAR-T therapy is essentially a powerful immunotherapy. Although it has remarkable efficacy, it also carries some risks of side effects, including cytokine release syndrome (CRS) and neurotoxic reactions. China’s CAR-T treatment system is highly developed, with established treatment plans and consensus. The country has extensive experience in managing CRS, neurotoxins, and side effects, keeping the risks very low. Moreover, the expert doctors at Advanced Medicine in China have substantial experience in managing these risks. Nonetheless, patients are typically required to have stable physical health to withstand the risks associated with the treatment.

– Overall good physical function; patients with heart, lung, liver, or kidney dysfunction may require a secondary evaluation by an expert team.

– Patients need to score 0-1 on the ECOG performance status scale, indicating that they are capable of daily activities and self-care.

## 3. **Patients with Financial and Time Support for CAR-T Therapy**

CAR-T therapy’s high cost and complex manufacturing process require patients and their families to have financial support. CAR-T therapy in China is significantly more affordable than in Western countries. While CAR-T treatments in the U.S. may cost $600,000 to $700,000, China’s approved CAR-T treatments cost around $100,000, about one-fifth to one-seventh of U.S. prices. Nevertheless, it remains a high-cost treatment, so patients need to be fully aware of the expenses involved.

China has invested heavily in CAR-T research in recent years. Many top hospitals and research institutions conduct related clinical trials. China accounts for over 50% of global CAR-T clinical trials. If a patient qualifies for a clinical trial, participating in it could be a more economical option, offering access to the latest CAR-T therapies, sometimes costing only tens of thousands of dollars or even free.

The CAR-T treatment process is relatively long. It involves collecting T cells, modifying them, re-injecting them, and close monitoring, requiring the patient to have enough time and patience to complete the entire process. The fastest known case took two weeks to complete all steps and discharge with complete response (CR), but generally, the process takes about four weeks or longer, depending on the patient’s condition.

For patients who can afford the treatment and have the time to complete it, CAR-T therapy in China is undoubtedly an attractive option.

## Conclusion

China’s leading position in CAR-T cell therapy technology and lower treatment costs make it a popular destination for multiple myeloma patients worldwide. It offers new hope for relapsed or refractory multiple myeloma patients. By working with experienced medical teams, patients can receive more personalized treatment plans and benefit from the rapid development of CAR-T therapy globally.

🎉🎉To assess whether the condition is suitable for CAR-T therapy, you can submit pathology reports, treatment history, and discharge summaries to the Medical Department of <Advanced Medicine in China> for preliminary evaluation!

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Email: doctor.huang@globecancer.com

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