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CART-Cell Therapy: Recent Advances and New Evidence in Multiple Myeloma.

Authors :
Martino, Massimo
Canale, Filippo Antonio
Alati, Caterina
Vincelli, Iolanda Donatella
Moscato, Tiziana
Porto, Gaetana
Loteta, Barbara
Naso, Virginia
Mazza, Massimiliano
Nicolini, Fabio
Ghelli Luserna di RorĂ , Andrea
Simonetti, Giorgia
Ronconi, Sonia
Ceccolini, Michela
Musuraca, Gerardo
Martinelli, Giovanni
Cerchione, Claudio
Source :
Cancers. Jun2021, Vol. 13 Issue 11, p2639. 1p.
Publication Year :
2021

Abstract

Simple Summary: Available data on anti-BCMA CART-cell therapy has demonstrated efficacy and manageable toxicity in heavily pretreated R/R MM patients. Despite this, the main issues remain to be addressed. First of all, a significant proportion of patients eventually relapse. The potential strategy to prevent relapse includes sequential or combined infusion with CAR T-cells against targets other than BCMA, CAR T-cells with novel dual-targeting vector design, and BCMA expression upregulation. Another dark side of CAR T therapy is safety. Cytokine release syndrome (CRS) and neurologic toxicity are well-described adverse effects. In MM trials, most CRS events tended to be grade 1 or 2. Another critical point is the extended timeline of the manufacturing process and that only a few academic centers can perform these procedures. Recognizing these issues, the excellent response with BCMA-targeted CAR T-cell therapy makes it a treatment strategy of great promise. Despite the improvement in survival outcomes, multiple myeloma (MM) remains an incurable disease. Chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA) represents a new strategy for the treatment of relapsed/refractory MM (R/R). In this paper, we describe several recent advances in the field of anti-BCMA CAR T-cell therapy and MM. Currently, available data on anti-BCMA CART-cell therapy has demonstrated efficacy and manageable toxicity in heavily pretreated R/R MM patients. Despite this, the main issues remain to be addressed. First of all, a significant proportion of patients eventually relapse. The potential strategy to prevent relapse includes sequential or combined infusion with CAR T-cells against targets other than BCMA, CAR T-cells with novel dual-targeting vector design, and BCMA expression upregulation. Another dark side of CART therapy is safety. Cytokine release syndrome (CRS) andneurologic toxicity are well-described adverse effects. In the MM trials, most CRS events tended to be grade 1 or 2, with fewer patients experiencing grade 3 or higher. Another critical point is the extended timeline of the manufacturing process. Allo-CARs offers the potential for scalable manufacturing for on-demand treatment with shorter waiting days. Another issue is undoubtedly going to be access to this therapy. Currently, only a few academic centers can perform these procedures. Recognizing these issues, the excellent response with BCMA-targeted CAR T-cell therapy makes it a treatment strategy of great promise. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20726694
Volume :
13
Issue :
11
Database :
Academic Search Index
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
150833487
Full Text :
https://doi.org/10.3390/cancers13112639