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Chimeric antigen receptor T cell therapy in multiple myeloma

Prof. Hermann Einsele, University of Würzburg, Germany
EHA 2019

Prof. Hermann Einsele (University of Würzburg, Germany) discussed CAR-T therapy in the multiple myeloma (MM) treatment pathway [1]. The take-home message of Prof. Einsele’s presentation was that CAR-T therapy be indicated in MM in the following three scenarios: (1) in patients who are not eligible for autologous transplant, CAR-T may consolidate or maintain remission; however, safety is a concern; (2) in patients who are eligible for autologous transplant there are 2 main groups who may benefit – those with adverse cytogenetics and those who progress early. In both populations, the long-term efficacy needs to be shown; and (3) heavily pre-treated patients (double-penta refractory) may also obtain some benefit, but the efficacy of CAR-T in this population must be shown with minimal residual disease (MRD)-negativity for prolonged PFS.

Patients with an MRD-negative state appear to have the same prognosis, regardless of whether they have standard or high-risk disease. However,...

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