Published on September 12, 2018
What does the future hold for CAR-T cell therapy and the standard of care for multiple myeloma? Will CAR T-cell therapy replace transplants? Myeloma experts Dr. Amrita Krishnan, from City of Hope, and Dr. Joshua Richter, from Mount Sinai School of Medicine, discuss current clinical trial research and explain how this approach compares to other approved myeloma therapies. What is the patient response? How will CAR T-cell therapy fit in with the current treatment landscape? Watch now to find out more.
This is a Patient Empowerment Network program produced by Patient Power. We thank AbbVie, Inc., Celgene Corporation, and Takeda Oncology for their support.
Transcript | A Look Ahead: Expert Perspective on CAR T-Cell Therapy vs. Transplants
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We have patients in our support group and I know across the nation saying, well, should I consider trying to get one of these CAR-T therapies instead of doing a transplant? Dr. Krishnan, let me ask you the question. Do you think one day that maybe CAR-T might replace transplants? Or how do you answer patients that have that question?
I don't—well, number one, I think that's 15 steps forward. If you look at the progression-free survival just from the Bluebird trial it was—it's not four years, which is what—or three years even what you'd see. Again those are relapsed patients.
Heavily pretreated, yeah.
Exactly. We do know too is you first have to reduce the amount of myeloma in the body for CAR-T to work well and also to reduce the toxicity of CAR-T. So you can't just take someone with newly diagnosed myeloma and give them CAR-T cells.
What we are looking at is the trial that was going to open through the BMT CTN (Blood & Marrow Transplant Clinical Trials Network) is patients that have very, very high-risk myeloma doing CAR-T cells after an autologous transplant. So really in a way you're trying to get the best of both worlds.
And, Dr. Richter, you would probably agree with that?
Absolutely. At the moment although CAR-T technology is extremely exciting it is not FDA-approved and as it's on clinical trials spots are unfortunately very limited, so at the moment the standard of care is still to move towards an autologous transplant. Having an autologous transplant does not make you ineligible for many of the CAR-T protocols.
The only type of transplant that limits options for CAR-T is allogeneic stem cell transplant, makes you ineligible for many but not all of the CAR-T protocols. But, again, the decision of which way to go now is going to change in the future and this is a conversation you should definitely have with your care team.