There is a strong need for durable, deep-response-inducing treatment for extramedullary multiple myeloma patients.
While immunotherapy treatments (such as CAR T-cell therapy) significantly improve the outcomes of several myeloma patients, can the same be said for those with extramedullary disease?
In the video below, Dr. Amrita Krishnan, a multiple myeloma specialist from City of Hope, explains the definition of extramedullary disease and why it’s considered high-risk.
The current treatments for multiple myeloma are excellent at targeting the bone marrow. However, multiple myeloma cells often lose their adhesive molecules over time, which keep them in the bone marrow, and migrate to other parts of the body, including the liver, chest, and brain.
The aggressive nature of extramedullary multiple myeloma classifies it as high-risk.
In the video below, three multiple myeloma specialists explain CAR T-cell therapy, how it works, and the potential side effects that might result from it.
CAR T-cell treatment is one of the most advanced forms of immunotherapy. A patient’s cells are collected, reegineered in a lab so they can recognize myeloma cells, and then infused back into the patient.
While CAR T-cell treatment has existed for around a decade in various diseases, it’s relatively new to the myeloma treatment field. As of June 2024, there are two CAR T-cell therapies approved to treat multiple myeloma. They are ciltacabtagene autoleucel (CARVYKTI, Johnson&Johnson) and idecabtagene vicleucel (Abecma, BMS).
An abstract shared at the 2024 ASCO (American Society of Clinical Oncology) Conference shared observations of extramedullary patients who had undergone the Idecabtagene Vicleucel (also referred to as ide-cel or Abecma) CAR T-cell therapy. Researchers included patients from 11 U.S. academic centers who fit this criteria between May 2021 and April 2023.
This cohort included 351 patients treated with ide-cel:
Patients with EMD were younger than those included in the non-EMD group, but their overall health status was worse.
After following up on these patients for 18 months after the infusion of the CAR-T, the researchers observed that:
If you are a visual learner and would like to see a table of the results, look here: EMD vs non-EMD Results
After adjusting for multiple variables, the researchers concluded that extramedullary disease was an independent predictor of poorer responses and a shorter progression-free survival after receiving ide-cel CAR T therapy.
Unfortunately, as previously reported in multiple studies, BCMA-targeted CAR T-cell therapy does not seem to be the breakthrough extramedullary disease patients and their loved ones seek.
However, it still remains an available treatment option for those who need another line of therapy and could potentially lead to a remission of several months.
Thankfully, we are seeing an increase in clinical trials designed with extramedullary disease and other high-risk features in mind. The field is more active than ever, so the breakthrough for extramedullary disease could be right around the corner.
Stay informed about potential treatments for extramedullary myeloma patients through the following resources.
Sources:
There is a strong need for durable, deep-response-inducing treatment for extramedullary multiple myeloma patients.
While immunotherapy treatments (such as CAR T-cell therapy) significantly improve the outcomes of several myeloma patients, can the same be said for those with extramedullary disease?
In the video below, Dr. Amrita Krishnan, a multiple myeloma specialist from City of Hope, explains the definition of extramedullary disease and why it’s considered high-risk.
The current treatments for multiple myeloma are excellent at targeting the bone marrow. However, multiple myeloma cells often lose their adhesive molecules over time, which keep them in the bone marrow, and migrate to other parts of the body, including the liver, chest, and brain.
The aggressive nature of extramedullary multiple myeloma classifies it as high-risk.
In the video below, three multiple myeloma specialists explain CAR T-cell therapy, how it works, and the potential side effects that might result from it.
CAR T-cell treatment is one of the most advanced forms of immunotherapy. A patient’s cells are collected, reegineered in a lab so they can recognize myeloma cells, and then infused back into the patient.
While CAR T-cell treatment has existed for around a decade in various diseases, it’s relatively new to the myeloma treatment field. As of June 2024, there are two CAR T-cell therapies approved to treat multiple myeloma. They are ciltacabtagene autoleucel (CARVYKTI, Johnson&Johnson) and idecabtagene vicleucel (Abecma, BMS).
An abstract shared at the 2024 ASCO (American Society of Clinical Oncology) Conference shared observations of extramedullary patients who had undergone the Idecabtagene Vicleucel (also referred to as ide-cel or Abecma) CAR T-cell therapy. Researchers included patients from 11 U.S. academic centers who fit this criteria between May 2021 and April 2023.
This cohort included 351 patients treated with ide-cel:
Patients with EMD were younger than those included in the non-EMD group, but their overall health status was worse.
After following up on these patients for 18 months after the infusion of the CAR-T, the researchers observed that:
If you are a visual learner and would like to see a table of the results, look here: EMD vs non-EMD Results
After adjusting for multiple variables, the researchers concluded that extramedullary disease was an independent predictor of poorer responses and a shorter progression-free survival after receiving ide-cel CAR T therapy.
Unfortunately, as previously reported in multiple studies, BCMA-targeted CAR T-cell therapy does not seem to be the breakthrough extramedullary disease patients and their loved ones seek.
However, it still remains an available treatment option for those who need another line of therapy and could potentially lead to a remission of several months.
Thankfully, we are seeing an increase in clinical trials designed with extramedullary disease and other high-risk features in mind. The field is more active than ever, so the breakthrough for extramedullary disease could be right around the corner.
Stay informed about potential treatments for extramedullary myeloma patients through the following resources.
Sources:
about the author
Audrey Burton-Bethke
Audrey is a content writer and editor for the HealthTree Foundation. She originally joined the HealthTree Foundation in 2020. Audrey loves spending time with her supportive husband, energetic four-year-old, and new baby.
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