My Treatment Approach Enhancing Treatment for Relapsed/Refractory Multiple Myeloma (RRMM): Converting Evidence to Effective Clinical Care - Episode 3
Exploring T-Cell Fitness Strategies to Optimize Clinical Outcomes in RRMM
Panelists discuss how bridging strategies such as selinexor, immunomodulatory drugs (IMiDs), and, potentially, immune checkpoint inhibitors (ICIs) can preserve or enhance T-cell fitness prior to chimeric antigen receptor T-cell therapy (CAR T), offering a dual benefit of disease control and improved therapeutic response in relapsed/refractory multiple myeloma (RRMM) patients.
Physician Summary: Bridging Strategies to Preserve or Enhance T-Cell Fitness Prior to CAR T
T-cell fitness is a key determinant of CAR T therapy success. Certain bridging strategies may help preserve or even enhance T-cell function during the waiting period before CAR T infusion.
Helpful Bridging Strategies:
- Selinexor: Has shown immunomodulatory effects on the tumor microenvironment and may enhance T-cell function, according to emerging data. It’s a viable option for disease control without significant T-cell suppression.
- IMiDs (eg, pomalidomide): Can support T-cell activation and persistence, and may boost CAR T efficacy when used prior to infusion.
- Immune checkpoint inhibitors (eg, nivolumab): Early data suggest potential to restore exhausted T cells and improve CAR T outcomes, though this remains investigational.
Key Takeaway: When bridging is required, selecting agents like selinexor, IMiDs, or possibly ICIs may offer dual benefit—disease control and preservation of T-cell fitness—improving the likelihood of a successful CAR T response.
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