Cargando…

Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease

In recent years, many new treatments for relapsed/refractory (R/R) multiple myeloma (MM) have improved patient prognosis, but the prognosis of patients with extramedullary MM is still particularly poor. Therefore, more efficacious therapies and novel strategies are urgently needed for these patients...

Descripción completa

Detalles Bibliográficos
Autores principales: Deng, Haobin, Liu, Meijing, Yuan, Ting, Zhang, Huan, Cui, Rui, Li, Jingyi, Yuan, Jijun, Wang, Xiaofang, Wang, Yafei, Deng, Qi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374046/
https://www.ncbi.nlm.nih.gov/pubmed/34421924
http://dx.doi.org/10.3389/fimmu.2021.720571
_version_ 1783740031414829056
author Deng, Haobin
Liu, Meijing
Yuan, Ting
Zhang, Huan
Cui, Rui
Li, Jingyi
Yuan, Jijun
Wang, Xiaofang
Wang, Yafei
Deng, Qi
author_facet Deng, Haobin
Liu, Meijing
Yuan, Ting
Zhang, Huan
Cui, Rui
Li, Jingyi
Yuan, Jijun
Wang, Xiaofang
Wang, Yafei
Deng, Qi
author_sort Deng, Haobin
collection PubMed
description In recent years, many new treatments for relapsed/refractory (R/R) multiple myeloma (MM) have improved patient prognosis, but the prognosis of patients with extramedullary MM is still particularly poor. Therefore, more efficacious therapies and novel strategies are urgently needed for these patients. The aim of this study was to observe and compare the efficacy and safety of humanized anti-B cell maturation antigen (anti-BCMA) chimeric antigen receptor (CAR) T cell therapy in R/R MM patients with and without extramedullary disease. Seven R/R MM patients with extramedullary disease and 13 without extramedullary disease received humanized anti-BCMA CAR T cell therapy. The overall response rate was not different between patients with and without extramedullary disease. There was no difference in the progression-free survival (PFS) or overall survival (OS) rates between the two groups at 180 days, but the PFS and OS rates in patients with extramedullary disease were lower at 360 days than those in patients without extramedullary disease. Although some patients with extramedullary disease experienced further disease progression, their M protein level did not increase. We did not see this change trend of M protein in patients without extramedullary disease. However, this was not observed in patients without extramedullary disease. Among patients who responded to CAR T cell therapy, the grades of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxic syndrome (ICANS) were much higher among patients with extramedullary disease. In summary, R/R MM patients with extramedullary disease could benefit from humanized anti-BCMA CAR T cell therapy in the short term, although the CRS and ICANS grades were much higher in patients with extramedullary disease. Therefore, anti-BCMA CAR T cell therapy allows for a remission time for R/R MM patients with extramedullary disease, which could be maintained by bridging hematopoietic stem cell transplantation, radiotherapy, and other therapies. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/index.aspx, identifiers ChiCTR1800017051 and ChiCTR2000033925.
format Online
Article
Text
id pubmed-8374046
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-83740462021-08-20 Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease Deng, Haobin Liu, Meijing Yuan, Ting Zhang, Huan Cui, Rui Li, Jingyi Yuan, Jijun Wang, Xiaofang Wang, Yafei Deng, Qi Front Immunol Immunology In recent years, many new treatments for relapsed/refractory (R/R) multiple myeloma (MM) have improved patient prognosis, but the prognosis of patients with extramedullary MM is still particularly poor. Therefore, more efficacious therapies and novel strategies are urgently needed for these patients. The aim of this study was to observe and compare the efficacy and safety of humanized anti-B cell maturation antigen (anti-BCMA) chimeric antigen receptor (CAR) T cell therapy in R/R MM patients with and without extramedullary disease. Seven R/R MM patients with extramedullary disease and 13 without extramedullary disease received humanized anti-BCMA CAR T cell therapy. The overall response rate was not different between patients with and without extramedullary disease. There was no difference in the progression-free survival (PFS) or overall survival (OS) rates between the two groups at 180 days, but the PFS and OS rates in patients with extramedullary disease were lower at 360 days than those in patients without extramedullary disease. Although some patients with extramedullary disease experienced further disease progression, their M protein level did not increase. We did not see this change trend of M protein in patients without extramedullary disease. However, this was not observed in patients without extramedullary disease. Among patients who responded to CAR T cell therapy, the grades of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxic syndrome (ICANS) were much higher among patients with extramedullary disease. In summary, R/R MM patients with extramedullary disease could benefit from humanized anti-BCMA CAR T cell therapy in the short term, although the CRS and ICANS grades were much higher in patients with extramedullary disease. Therefore, anti-BCMA CAR T cell therapy allows for a remission time for R/R MM patients with extramedullary disease, which could be maintained by bridging hematopoietic stem cell transplantation, radiotherapy, and other therapies. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/index.aspx, identifiers ChiCTR1800017051 and ChiCTR2000033925. Frontiers Media S.A. 2021-08-05 /pmc/articles/PMC8374046/ /pubmed/34421924 http://dx.doi.org/10.3389/fimmu.2021.720571 Text en Copyright © 2021 Deng, Liu, Yuan, Zhang, Cui, Li, Yuan, Wang, Wang and Deng https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Deng, Haobin
Liu, Meijing
Yuan, Ting
Zhang, Huan
Cui, Rui
Li, Jingyi
Yuan, Jijun
Wang, Xiaofang
Wang, Yafei
Deng, Qi
Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title_full Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title_fullStr Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title_full_unstemmed Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title_short Efficacy of Humanized Anti-BCMA CAR T Cell Therapy in Relapsed/Refractory Multiple Myeloma Patients With and Without Extramedullary Disease
title_sort efficacy of humanized anti-bcma car t cell therapy in relapsed/refractory multiple myeloma patients with and without extramedullary disease
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374046/
https://www.ncbi.nlm.nih.gov/pubmed/34421924
http://dx.doi.org/10.3389/fimmu.2021.720571
work_keys_str_mv AT denghaobin efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT liumeijing efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT yuanting efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT zhanghuan efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT cuirui efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT lijingyi efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT yuanjijun efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT wangxiaofang efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT wangyafei efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease
AT dengqi efficacyofhumanizedantibcmacartcelltherapyinrelapsedrefractorymultiplemyelomapatientswithandwithoutextramedullarydisease