一家研究中心应用 T 细胞重定向疗法治疗三类难治性多发性骨髓瘤的经验

The efficacies of chimeric antigen receptor T cells (CAR-Ts) and bispecific monoclonal antibodies (BiAbs) for triple-class refractory (TCR) myeloma have not previously been compared, and clinical data on how to rescue patients after relapse from these immunotherapies are limited. A retrospective study of 73 TCR patients included in trials was conducted: 36 received CAR-Ts and 37 received BiAbs. CAR-Ts produced a higher overall response rate (ORR) than BiAbs (97. 1% vs 56. 8%, P = . 002). After a median of follow-up of 18. 7 months, no significant difference in progression-free survival (PFS) was observed between the CAR-T and BiAbs groups (16. 6 vs 10. 8 months; P = .

090), whereas overall survival (OS) was significantly longer in the CAR-T than in the BiAbs group (49. 2 vs 22. 6 months; P = . 021). BiAbs after CAR-Ts yielded a higher ORR and longer PFS2 than did nonredirecting T-cell therapies after CAR-Ts (ORR: 87. 5% vs 50. 0%; PFS2: 22. 9 vs 12. 4 months). By contrast, BiAbs after BiAbs resulted in an ORR of 33% and PFS2 of 8.

4 months, which was similar to that produced by the nonredirecting T-cell therapies (ORR: 28. 6%; PFS2: 8. 1 months). Although this is a pooled analysis of different trials with different products and the patient profile is different for CAR-Ts and BiAbs, both were effective therapies for TCR myeloma.

However, in our experience, although the PFS was similar with the 2 approaches, CAR-T therapy resulted in better OS, mainly because of the efficacy of BiAbs as rescue therapy.

Our results highlight the importance of treatment sequence in real-word experience.