Multiple Myeloma Treatment by Synergistic Action of CAR-T Cells

Release Date: 16-Sep-2019

In the patients of multiple myeloma, a synergistic action of a combination of humanized anti-CD19 and anti-B-cell maturation antigen chimeric antigen receptor T-cells has observed in a phase II clinical trial published in Lancet Haematology. This combination results in the 95% response rate, with complete response in about 43% patient.

This is the first study which involves humanized anti-CD19 CAR T cells combined with anti-BCMA CAR T cells for the treatment of relapsed or refractory multiple myeloma. B-cell maturation antigen (BCMA) is an ideal target for CAR T-cell therapy, and superior results have been obtained in relapsed or refractory multiple myeloma. Several studies confirm that a minor component of multiple myeloma clones expresses CD19, and these cells are considered to be less differentiated multiple myeloma cells.

This combinational strategy expands the coverage of multiple myeloma cell targets and eliminates the less-differentiated multiple myeloma cells. This result in the strategy with improved duration of response of CAR T-cell activity in patients with relapsed or refractory multiple myeloma.

Furthermore, increased durability of responses is impressive and supports further study of this approach, huge caution in attributing these satisfactory outcomes to the supplementary targeting of CD19. In this trial, there was no receiver of the anti-BCMA CAR-T cells alone, and the anti-BCMA CAR T cells used had not previously been reported as monotherapy

Work on this combination was done by Kailin Xu, MD, PhD, professor in the department of hematology at the Affiliated Hospital of Xuzhou Medical University. According to Xu, the results confirm that combined therapy of humanized anti-CD19 and anti-BCMA CAR T cells is achievable in patients with relapsed or refractory multiple myeloma, and the preliminary activity warrants further investigation in randomized trials.