Information in a Specialty Pharmacy Times report indicates that immunotherapy combined with chemotherapy may be an effective option for patients with drug-resistant multiple myeloma who have relapsed.
Multiple myeloma is a rare form of cancer that develops in bone plasma cells, which are a type of white blood cell. Plasma cells help fight infections by making antibodies that attack diseases. In contrast, cancer cells create abnormal proteins (antigens) that cause complications in the body. When cancer cells crowd out the healthy plasma cells in the bone marrow, there aren’t enough antibodies being produced to fight off the cancer cells. Symptoms of this disease include bone tumors, kidney problems, and anemia. To read more about multiple myeloma, click here.
As reported at the recent Annual American Society of Hematology Meeting and Exposition, researchers have been studying different kinds of immunotherapy for multiple myeloma patients. Immunotherapy treatment uses the body’s immune system to help fight diseases like cancer. This can be done by stimulating the immune system to work harder in attacking cancer cells. Or, patients can take immune system components, like synthesized (man-made) immune system proteins.
The first study discussed involved CAR T-cell therapy delivered after chemotherapy. CAR T-cell therapy reprograms immune cells called T-cells to find and destroy cancer cells by altering them in the lab.
Another strategy involved monoclonal antibody infusions. These are antibodies made to target a specific antigen, which are then copied in a lab and administered to patients. Both methods acted on the B-Cell Maturation Antigen (BCMA) receptor, a treatment target for multiple myeloma.
In the monoclonal antibody study, researchers used GSK2857916, an experimental drug granted breakthrough therapy designation, along with chemotherapy to target BCMA.
Patients got infusions every 3 weeks for up to 16 cycles, and yielded an overall response rate of 60%. Noted complications were reports of significant eye toxicity, but researchers stated that this was due to the chemotherapy, not the monoclonal antibodies. One researcher said that response rates that high were quite unprecedented.
In the CAR T-cell therapy, researchers used the drug CART-BCMA to reprogram patients’ cells to target the invading cancer cells. The process included chemotherapy to lower white blood cells, and then an infusion of two doses of the drug. After the infusion, the T-cells targeted the BCMA-expressing cells. The treatment induced a response in 64% of patients. However, it’s important to note that 80% of the patients developed cytokine-release syndrome. This is characterized by flu-like symptoms.
The CAR T-cell trial is ongoing, with more patients participating and receiving higher doses of the CART-BCMA therapy, as well as tocilizumab and siltuximab, which are cytokine inhibitors.
Considering the reported response rates here, as well as the ongoing studies, it is exciting to see how immunotherapy options impact multiple myeloma treatment down the road.