October 1, 2020
Researchers are investigating whether combinations of CAR T-cell therapies might improve outcomes
- The FDA has accepted the CAR T-cell immunotherapy, bb2121, for priority review
- One advantage to this therapy is it can give patients a year with no progression
- Research is under way to test CAR T-cell therapies against various targets
In September, the FDA accepted idecabtagene vicleucel (bb2121) for priority review. This investigational chimeric antigen receptor (CAR) T-cell immunotherapy is designed to treat patients with multiple myeloma who have received at least three previous therapies, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody. The therapy is novel in that it targets B-cell maturation antigen (BCMA), which is a promising target in multiple myeloma.
“I think a lot of patients will be very excited to try it once it gets FDA-approved,” Dr. Nina Shah, hematologist-oncologist at UCSF Medical Center, tells SurvivorNet. One advantage to this therapy is it can give patients a year without progression, or the need for additional treatment. “Many patients really want a taste of that one year without having extra therapy.”
One disadvantage is the time required to harvest and then engineer a patient’s cells. “Now that time may be getting shorter and shorter, but that still can be a significant hurdle for some patients,” says Dr. Natalie Callander, hematologist-oncologist at UW Health. She suspects CAR T-cell therapy will only be available at academic centers for the time being, given the expertise needed to anticipate and manage side effects.
Efforts in the future may determine which BCMA-targeted therapies will work synergistically. For example, studies are investigating which combinations of CAR T-cell therapies might be more effective. Another area of research interest is to test these therapies against several potential therapeutic targets, “with the hope that perhaps that could result in a greater benefit,” says Dr. Robert Orlowski, chairman, ad interim, and director of myeloma at MD Anderson Cancer Center.