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Review
. 2020 Jul 28:10:1243.
doi: 10.3389/fonc.2020.01243. eCollection 2020.

CAR T-Cells in Multiple Myeloma: State of the Art and Future Directions

Luis Gerardo Rodríguez-Lobato  1   2 , Maya Ganzetti  1   3 , Carlos Fernández de Larrea  2 , Michael Hudecek  1 , Hermann Einsele  1 , Sophia Danhof  1
Affiliations
Review

CAR T-Cells in Multiple Myeloma: State of the Art and Future Directions

Luis Gerardo Rodríguez-Lobato et al. Front Oncol. .

Abstract

Despite recent therapeutic advances, the prognosis of multiple myeloma (MM) patients remains poor. Thus, new strategies to improve outcomes are imperative. Chimeric antigen receptor (CAR) T-cell therapy has changed the treatment landscape of B-cell malignancies, providing a potentially curative option for patients who are refractory to standard treatment. Long-term remissions achieved in patients with acute lymphoblastic leukemia and Non-Hodgkin Lymphoma encouraged its further development in MM. B-cell maturation antigen (BCMA)-targeted CAR T-cells have established outstanding results in heavily pre-treated patients. However, several other antigens such as SLAMF7 and CD44v6 are currently under investigation with promising results. Idecabtagene vicleucel is expected to be approved soon for clinical use. Unfortunately, relapses after CAR T-cell infusion have been reported. Hence, understanding the underlying mechanisms of resistance is essential to promote prevention strategies and to enhance CAR T-cell efficacy. In this review we provide an update of the most recent clinical and pre-clinical data and we elucidate both, the potential and the challenges of CAR T-cell therapy in the future.

Keywords: B-cell maturation antigen; T-cell; chimeric antigen receptor; cytokine release syndrome; immunotherapy; multiple myeloma.

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Figures

Figure 1
Figure 1
Structural elements of a chimeric antigen receptor.
Figure 2
Figure 2
Strategies to overcome resistance mechanisms to CAR T-cell therapy in multiple myeloma.
See this image and copyright information in PMC

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