ASH 2019 Day 1 – Improving CAR T-Cell Therapy Session

DAY 1 – Afternoon Session

The last abstract to be covered for today focuses on chimeric antigen receptor (CAR) T-cell therapy that targets B-cell maturation antigen (BCMA) on myeloma cells. While CAR T-cell therapy remains an exciting new strategy to combat myeloma with impressive response rates in patients who often have relapsed following multiple therapies, the biggest challenge is that responses are not always durable and many patients will still relapse. Why CAR T-cell therapy is not long-lived is still unknown.

Dr. Andrew Cowan from the University of Washington reported on a novel way to increase the amount of BCMA on myeloma cells so that CAR T-cells can remain circulating in a patient’s body longer which will help hold off relapse  (ABSTRACT 204 https://ash.confex.com/ash/2019/webprogram/Paper129405.html). Dr. Cowan and his colleagues conducted a clinical trial that combines CAR T cells with another drug called gamma secretase inhibitors (GSIs) which increase BCMA expression on myeloma cells.

Eight patients with relapsed/refractory myeloma were treated with this combination and all patients responded. So far, to date, no patient has relapsed at a median follow-up of 5 months. All patients experienced cytokine release syndrome (CSR)—typically mild—and 70% of patients had some neurotoxicity. While these results are encouraging, longer follow up is needed to confirm that this approach will result in long-term durability of response.