Anti-BCMA/CD19 CAR T Cells with Early Immunomodulatory Maintenance for Multiple Myeloma Responding to Initial or Later-Line Therapy
| Autor: | Alfred L. Garfall, Adam D. Cohen, Sandra P. Susanibar-Adaniya, Wei-Ting Hwang, Dan T. Vogl, Adam J. Waxman, Simon F. Lacey, Vanessa E. Gonzalez, Joseph A. Fraietta, Minnal Gupta, Irina Kulikovskaya, Lifeng Tian, Fang Chen, Natalka Koterba, Robert L. Bartoszek, Margaret Patchin, Rong Xu, Gabriela Plesa, Don L. Siegel, Andrea Brennan, Anne Marie Nelson, Regina Ferthio, Angela Cosey, Kim-Marie Shea, Rachel Leskowitz, Megan Four, Wesley V. Wilson, Fei Miao, Eric Lancaster, Beatriz M. Carreno, Gerald P. Linette, Elizabeth O. Hexner, Regina M. Young, Dexiu Bu, Keith G. Mansfield, Jennifer L. Brogdon, Carl H. June, Michael C. Milone, Edward A. Stadtmauer |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Blood Cancer Discovery. 4:118-133 |
| ISSN: | 2643-3249 2643-3230 |
| Popis: | We conducted a phase I clinical trial of anti-BCMA chimeric antigen receptor T cells (CART-BCMA) with or without anti-CD19 CAR T cells (huCART19) in multiple myeloma (MM) patients responding to third- or later-line therapy (phase A, N = 10) or high-risk patients responding to first-line therapy (phase B, N = 20), followed by early lenalidomide or pomalidomide maintenance. We observed no high-grade cytokine release syndrome (CRS) and only one instance of low-grade neurologic toxicity. Among 15 subjects with measurable disease, 10 exhibited partial response (PR) or better; among 26 subjects responding to prior therapy, 9 improved their response category and 4 converted to minimal residual disease (MRD)–negative complete response/stringent complete response. Early maintenance therapy was safe, feasible, and coincided in some patients with CAR T-cell reexpansion and late-onset, durable clinical response. Outcomes with CART-BCMA + huCART19 were similar to CART-BCMA alone. Collectively, our results demonstrate favorable safety, pharmacokinetics, and antimyeloma activity of dual-target CAR T-cell therapy in early lines of MM treatment.Significance:CAR T cells in early lines of MM therapy could be safer and more effective than in the advanced setting, where prior studies have focused. We evaluated the safety, pharmacokinetics, and efficacy of CAR T cells in patients with low disease burden, responding to current therapy, combined with standard maintenance therapy.This article is highlighted in the In This Issue feature, p. 101 |
| Databáze: | OpenAIRE |
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