Multitargeted CAR T-cell therapy in multiple myeloma
Mené sur 21 patients atteints d'un myélome multiple réfractaire ou récidivant, cet essai de phase II évalue l'efficacité, du point de vue de la proportion de patients obtenant une réponse globale, et la toxicité de lymphocytes CAR-T ciblant CD19 et de lymphocytes CAR-T ciblant BCMA administrés de façon combinée (durée médiane de suivi : 179 jours)
Multiple myeloma remains an incurable disease for most patients despite the advent of novel therapies. Advances in the field of adoptive immunotherapy using chimeric antigen receptor (CAR) T cells have brought new hope for multiple myeloma patients. Published phase 1 studies with anti-B-cell maturation antigen (BCMA) CAR T cells have yielded impressive responses in patients with relapsed or refractory multiple myeloma. Overall response in these studies, at the higher cell doses, ranged from 64–90%, which is remarkable in a population that had received 7–8 previous lines of therapy and was enriched for patients with poor-prognosis cytogenetic abnormalities. However, in comparison to the long-term responses and potential for cure seen with anti-CD19 CAR T cells in B-cell acute lymphoblastic leukaemia, diffuse large B-cell lymphoma, and chronic lymphocytic leukaemia, the responses to CAR T-cell therapy for patients with multiple myeloma have not been as durable. Although many patients on the published anti-BCMA CAR T-cell trials 1
achieved months of disease control, long-term responses (>2 years) were rare.
The Lancet Haematology , commentaire, 2018