BCMA-directed CAR T cell therapy is safe in patients with relapsed or refractory multiple myeloma and CNS involvement
MD Anderson Research Highlight March 21, 2025
Due to the risk of associated neurotoxicities, some clinicians are hesitant to consider B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T (CAR T) cell therapy for patients with relapsed or refractory multiple myeloma and central nervous system (CNS) involvement. In a multicenter retrospective analysis led by ., and ., researchers investigated the use of two BCMA-targeting CAR T cell therapies to identify any excessive neurotoxicity. In the study, six patients received idecabtagene vicleucel and four received ciltacabtagene autoleucel. Trial participants had an overall response rate of 80% and a 100% CNS response. With a median follow-up of 381 days, patients diagnosed with CNS involvement before receiving CAR T cell therapy had a median overall survival and progression-free survival of 13.3 and 6.3 months, respectively. Four patients who responded to bridging therapy had the best outcomes, suggesting that optimizing pre-CAR T cell therapy may be crucial for improved outcomes. The researchers identified no excess toxicities and suggest further research is warranted on CAR T cell therapy in a larger population of patients with CNS multiple myeloma. Learn more in