CAR T and Bispecifics Take Center Stage in New Myeloma Trials


Adam D. Cohen, MD, discusses ongoing research influencing the multiple myeloma treatment landscape.

Adam D. Cohen, MD, associate professor of medicine at the Hospital of the University of Pennsylvania, discusses ongoing research influencing the multiple myeloma treatment landscape.

Specifically, Cohen highlights some studies that are moving chimeric antigen receptor (CAR) T-cell therapies and bispecifics earlier in the course of treatment.


0:09 | We are fortunate to have so many new trials coming out as well. I think starting with the existing agents, there are a number of studies that are moving CAR T cells or bispecifics much earlier in the course of myeloma treatment and not waiting until patients have had 3, 4, or 5 lines of therapy. There are studies in early relapse, and there are even studies for newly diagnosed patients, either as a consolidation therapy after induction, or for patients who have had a stem cell transplant but have not had an optimal response. There are some small pilot studies that have been done showing feasibility. Now, there are some big, international, randomized phase 3 trials where either CAR T cells or bispecifics are going to go head-to-head with our standard therapies, including stem cell transplant, so this is really exciting. We are also hoping that moving these earlier may make them work better, and perhaps get to that elusive cure.

1:04 | In terms of other things coming out, there are a number of other bispecifics and CAR T-cell products that are being developed. One is a drug called cevostamab, which is a bispecific targeting FcRH5, another tumor antigen that is on the surface of myeloma cells, showing some interesting preliminary data in relapsed/refractory patients and being explored in earlier settings as well. Then there are a whole bunch of new cell therapies coming out, rapid manufacturing CAR T-cell products where the vein-to-vein time can be under 2 weeks and [we] can get it into patients much faster, allogeneic CAR [T-cell] products where they are using healthy donor T cells to be off-the-shelf, and even cellular therapies where they are using natural killer cells, so called CAR NK, which is another way to target the tumor, in this case, myeloma, but perhaps in a less toxic fashion than with CAR T cells. All of these are entering early phase trials, and we are eagerly awaiting the results.

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