Leveraging “Exciting” CAR T-Cell Therapy Advancements in Multiple Myeloma


Whether CAR T-cell therapy or T-cell engagers should dominate the multiple myeloma landscape may be hard to determine, says David S. Siegel, MD.

It will be “exciting” to learn how to move forward with novel therapeutic options such as T-cell engaging therapies in the multiple myeloma space while discovering how to minimize the toxicity associated with these agents, according to David S. Siegel, MD, PhD.

In a discussion with CancerNetwork® at the 2024 American Society of Clinical Oncology (ASCO), Siegel, chief of the Multiple Myeloma Division at John Theurer Cancer Center of Hackensack University Medical Center in Hackensack, New Jersey, spoke about potentially practice-changing developments in the multiple myeloma field, particularly those related to CAR T-cell therapies and other alternative agents.

Although BCMA-directed agents are currently the only widely available drugs in this treatment class, Siegel considered the potential interplay that may develop between CAR T-cell therapy and other emerging therapies including T-cell engagers. According to Siegel, there are currently no data to help address the question of whether CAR T-cell therapies or T-cell engagers should be employed more often than the other as potential treatment options continue to expand in the field.


Right now, the only CAR T-cell [therapies] that we have routine access to are BCMA-directed CAR T [cells]. We now have products that are going to have alternative targets. What is going to be the interplay between the increasing number of choices that we have in CAR T-cell products and the increasing number of choices that we have in T-cell engagers? Which products will or should dominate those spaces? That’s a very difficult question that we have literally no data to address.

We have some independent data in certain spaces, but we haven’t looked at what the sequencing should be and whether CAR T cells should be used exclusively when they’re available. Or, should we be moving to T-cell engagers? I also think that we haven’t figured out how to use T-cell engagers correctly yet. It’s going to be very exciting as we move forward and learn to use them and minimize the toxicities that are associated with them.

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