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EHA 2024 | The role of CAR T-cell therapy for treating myeloma in the era of bispecific antibodies
Saad Usmani, MD, MBA, FACP, Memorial Sloan Kettering Cancer Center, New York, NY, discussed the unprecedented response rates in heavily pretreated patients with multiple myeloma (MM) treated with CAR T-cell therapies and other immunotherapies, highlighting the potential benefits and challenges of these treatments. Dr Usmani notes that, while CAR-T therapies offer a one-time treatment option with no maintenance therapy, they are associated with challenges such as manufacturing time, patient eligibility, and access. This interview took place at the 29th Congress of the European Hematology Association (EHA) in Madrid, Spain.
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Transcript
So we are in this wonderful, you know, era of, immunotherapies in myeloma. We’re seeing unprecedented response rates in late line patients with CAR T-cell therapies, with immunotherapies. And I think that there is room for all of these strategies, whether it’s CAR-Ts, bispecifics, you know, or the combination of different bispecifics, or combinations of bispecifics with other immunomodulatory strategies...
So we are in this wonderful, you know, era of, immunotherapies in myeloma. We’re seeing unprecedented response rates in late line patients with CAR T-cell therapies, with immunotherapies. And I think that there is room for all of these strategies, whether it’s CAR-Ts, bispecifics, you know, or the combination of different bispecifics, or combinations of bispecifics with other immunomodulatory strategies. If we were in Utopia and we had unlimited capacity, CAR-Ts would probably be the preferred choices of treatment for patients because, you know, you’re able to deliver a dose, and then patients recover and they’re not on any maintenance therapy. So, there’s a different proposition of quality of life after that initial phase. Whereas with bispecifics it’s more of a continuous therapy model.
There are also inherent challenges with manufacturing CAR-T, it takes a while for us to collect the cells and then manufacture. And during that time, for a month and a half or two, we still have to control the patient’s disease. And then there’s the safety profile component as well. So, you know, there are pros and cons to CARs and bispecifics and I think in the future, what we’re going to be looking for is patients who are CAR eligible versus not and picking treatments appropriately. And then for CAR eligibility, you know, access would be also an important piece. You know, how far away the patient lives from the cellular therapy center, do they have the social support and mechanism and infrastructures to, you know, help them take through that particular strategy? So I think it’s a good problem to have.
I think both of these therapies are very important and they will help us get better survival outcomes for many more patients than we do today.
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Disclosures
Research funding: Abbvie, Amgen, Array Biopharma, BMS, Celgene, GSK, Janssen, Merck, Pharmacyclics, Sanofi, Seattle Genetics, SkylineDX, Takeda. Consulting: Abbvie, Amgen, BMS, Celgene, EdoPharma, Genentech, Gilead, GSK, Gracell Therapeutics, Janssen, Oncopeptides, Sanofi, Seattle Genetics, SecuraBio, SkylineDX, Takeda, TeneoBio.
