Causes for Relapse in Multiple Myeloma With CAR T cells

Eric Smith, MD, PhD

Eric Smith, MD, PhD, discusses challenges with CAR T-cell therapy as a treatment option for multiple myeloma. While studies have shown CD19 CAR T cells and BCMA CAR T cells have durable responses in this patient population, patients still relapse over time.

Eric Smith, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses challenges with CAR T-cell therapy as a treatment option for multiple myeloma. While studies have shown CD19 CAR T cells and BCMA CAR T cells have durable responses in this patient population, patients still relapse over time.

According to Smith, there are 2 reasons that this happens. The first is that the target antigen is downregulated or not expressed in small populations of cells, and the cells end up growing. Another reason is that the myeloma relapse is still expressing the target because the T cells are no longer functionally persistent. Therefore, they are unable to do a good job in dividing and killing the cells.