Lenalidomide enhances the efficacy of anti-BCMA CAR-T treatment in relapsed/refractory multiple myeloma: a case report and revies of the literature

Autor: Mingxing Xiao, Yi Wu, Feng He, Zhi Cheng, Lei Feng, Runhong Wei, Guoxing Zhao
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Transplantation Conditioning
Cyclophosphamide
medicine.medical_treatment
Immunology
Hematopoietic stem cell transplantation
Immunotherapy
Adoptive
03 medical and health sciences
0302 clinical medicine
Multiple myeloma
Chimeric antigen receptor T cell
Recurrence
Internal medicine
medicine
Humans
Immunologic Factors
Immunology and Allergy
B-Cell Maturation Antigen
Adverse effect
Lenalidomide
Chemotherapy
Receptors
Chimeric Antigen
business.industry
Hematopoietic Stem Cell Transplantation
Immunoglobulin D
Middle Aged
medicine.disease
Chemotherapy regimen
Fludarabine
B cell maturation antigen
Treatment Outcome
030104 developmental biology
030220 oncology & carcinogenesis
Original Article
business
Proteasome Inhibitors
Vidarabine
medicine.drug
Zdroj: Cancer Immunology, Immunotherapy
ISSN: 1432-0851
0340-7004
DOI: 10.1007/s00262-021-02959-8
Popis: We report successful clinical experience using anti-BCMA CAR-T combined with lenalidomide in a patient who was refractory to a previous CAR-T treatment. The patient was a 51-year-old man, and was diagnosed with IgD-λ multiple myeloma(MM) in October 2015. 10 courses of chemotherapy including immunomodulators and proteasome inhibitors were used for remission and autologous hematopoietic stem cell transplantation was performed. MM relapsed after 12 months of remission. His disease continued to progress after multiple chemotherapy regimens, mouse anti-BCMA CAR-T and human-derived anti-BCMA CAR-T therapy. After a conditioning chemotherapy regimen of fludarabine and cyclophosphamide, patient took lenalidomide on day -1 and human-derived anti-BCMA CAR-T cells were infused on the next day. He suffered grade 2 cytokine-releasing syndrome(CRS) and grade 3 myelosuppression after infusion, and were resolved after symptomatic treatment. Very good partial response (VGPR) was achieved 14 days after CAR-T treatment, and had been maintained for more than 8 months. We demonstrated for the first time in patients that anti-BCMA CAR-T cell therapy combined with lenalidomide is feasible and effective in the treatment of RRMM. It provides a new strategy for RRMM patients who do not respond to anti-BCMA CAR-T cell therapy alone, and the adverse event is reversible.
Databáze: OpenAIRE
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