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iwHRMM 2025 | The potential of CAR-T to improve the outcomes of patients with high-risk myeloma
Doris Hansen, MD, Moffitt Cancer Center, Tampa, FL, discusses the differences in responses and survival outcomes following CAR T-cell therapy in patients with high-risk versus standard-risk multiple myeloma (MM). Dr Hansen notes that although patients with high-risk disease may have less durable responses, CAR T-cell therapies still offer improved outcomes compared to other treatment strategies. This interview took place at the 2nd International Workshop on High-Risk Multiple Myeloma (iwHRMM 2025), held in Charleston, SC.
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Transcript
We’ve seen that even with CAR T-cell therapies, patients who have high-risk features such as high-risk cytogenetics, extramedullary disease, some of the other high-risk features like plasma cell leukemia, CNS involvement, we know that these patients generally, while they might respond, their responses are much less durable and their progression-free survival is significantly shorter...
We’ve seen that even with CAR T-cell therapies, patients who have high-risk features such as high-risk cytogenetics, extramedullary disease, some of the other high-risk features like plasma cell leukemia, CNS involvement, we know that these patients generally, while they might respond, their responses are much less durable and their progression-free survival is significantly shorter. Nonetheless, we do see that these responses are much better than what we’ve seen with some of the other agents. So CAR-T and even today in the meeting, we talked about RedirecTT-1, for example, with tal and teq, particularly in patients with extramedullary disease, those patients are actually getting a good response.
Another very nice and elegant analysis is CARTITUDE-4, looking at patients with functional high-risk disease, which is really one of the highest risk, I would say, populations in terms of patients with multiple myeloma. What was impressive about that with cilta-cel is that, you know, if they had received at least one prior line of therapy and had standard or functional high-risk disease, they had durable responses and their 12-month progression-free survival was nearly identical. So certainly it’s promising. And then a subgroup analysis for CARTITUDE-4 at ASCO presented by Dr. Sadana did show that cilta-cel might potentially overcome some of these high-risk features. So results are encouraging, and certainly we have many more novel targets and immunotherapies in development that will be promising, hopefully, for our patients.
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