David E. Avigan, MD, professor of medicine, Harvard Medical School, and active staff, Hematology-Oncology, Beth Israel Deaconess Medical Center, discusses BCMA-targeted CAR T-cell therapies in multiple myeloma.

BCMA-targeted CAR T-cell therapy is a potent treatment strategy that provides another line of therapy to heavily pretreated patients, says Avigan. However, one has to be aware of the potential treatment-related adverse events (TRAEs), such as neurotoxicity and cytokine release syndrome. Generally, the TRAEs are manageable, but patients have to be monitored closely, nonetheless.

Although the modality has demonstrated high objective response rates in this patient population, they tend to drop off after the first year of treatment, explains Avigan. As such, there is a lot of ongoing work aimed at addressing patterns of resistance to CAR T-cell therapy in an attempt to improve upon T-cell persistence.

Videos

David E. Avigan, MD, professor of medicine, Harvard Medical School, and active staff, Hematology-Oncology, Beth Israel Deaconess Medical Center, discusses BCMA-targeted CAR T-cell therapy in multiple myeloma.

Dr. Avigan on BCMA-Targeted CAR T-Cell Therapy in Multiple Myeloma

David E. Avigan, MD, professor of medicine, Harvard Medical School, and active staff, Hematology-Oncology, Beth Israel Deaconess Medical Center, discusses research surrounding CAR T-cell therapy in lymphoproliferative diseases.

CAR T-cell therapy, according to Avigan, has been transformative in lymphoproliferative diseases such as acute lymphocytic leukemia and non-Hodgkin lymphoma. The approach is now being investigated in multiple myeloma with a focus on BCMA as a target, which is predominantly expressed in plasma cells.

The results with CAR T-cell therapy vary and have included some high response rates, including in patients with advanced disease. The next step is to examine the durability of these responses. One study with longer follow-up suggested a median time of response of 12 months, with a little duration of response in patients with advanced disease.

Avigan believes researchers need to make progress in understanding why patients are relapsing and what can be done to preserve response. Efforts to do so include investigating mechanisms of resistance and sequencing of CAR T-cell therapy, concludes Avigan.

David E. Avigan, MD, discusses research surrounding CAR T-cell therapy in lymphoproliferative diseases.

David E. Avigan, MD

Articles

Dr. Avigan on BCMA-Targeted CAR T-Cell Therapy in Multiple Myeloma

Dr. Avigan on CAR T-Cell Therapy in Lymphoproliferative Disease