Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany.
Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany.
Eur J Haematol. 2024 Jan;112(1):19-27. doi: 10.1111/ejh.14051. Epub 2023 Aug 7.
The introduction of chimeric antigen receptor (CAR) T cells revolutionized treatment of relapsed and refractory multiple myeloma (RRMM) in recent years. Currently, two CAR T cell products-idecabtagene vicleucel and ciltacabtagene autoleucel-are approved in the United States and the European Union to treat patients with three prior lines of therapy, including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 antibody. Moreover, seminal phase III trials of both agents in earlier lines of therapy have been published recently. Despite unprecedented rates of deep and lasting remissions in RRMM, there are still areas of uncertainty regarding the optimal use and distribution of CAR T cells in multiple myeloma. In the current review, we discuss the available data on approved CAR T cell products as well as unmet clinical needs and ongoing developments to optimize usage of this promising treatment modality in multiple myeloma.
近年来，嵌合抗原受体 (CAR) T 细胞的引入彻底改变了复发和难治性多发性骨髓瘤 (RRMM) 的治疗方法。目前，两种 CAR T 细胞产品——idecabtagene vicleucel 和 ciltacabtagene autoleucel——已在美国和欧盟获得批准，可用于治疗接受过三线治疗的患者，包括蛋白酶体抑制剂、免疫调节剂和抗 CD38 抗体。此外，最近还公布了这两种药物在更早治疗线中的关键性 III 期试验结果。尽管 RRMM 患者的深度和持久缓解率达到了前所未有的水平，但在 CAR T 细胞在多发性骨髓瘤中的最佳使用和分布方面仍存在不确定性。在当前的综述中，我们讨论了已批准的 CAR T 细胞产品的现有数据以及未满足的临床需求和正在进行的开发，以优化这种有前途的治疗方式在多发性骨髓瘤中的应用。
