Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

Click the orange button to the right to learn more about what you can start doing today.

CAR-T Adverse Events

Share Button

CAR-T therapy holds a great deal of potential for multiple myeloma patients and survivors. I read about a growing number of MM patients undergoing CAR-T therapy almost daily. According to the research linked below, everyone undergoing CAR-T therapy develops serious adverse events aka side effects.

For the first time ever, a client told me that he was newly diagnosed and seriously considering CAR-T therapy for his first line of therapy. I thought I should study up on the pros and cons of CAR-T therapy for MM.

I am a long-term MM survivor. Induction, consolidation, and an ASCT taught me that conventional oncology may not talk about or explain adverse events aka side effects.

I say this because I live with many serious long-term side effects. All from FDA approved “safe and effective” chemotherapy and radiation.

Don’t misunderstand me. The MM patient who has relapsed 3,4 maybe even 5 times, who has run out of therapy options may undergo CAR-T therapy. I understand this. I’m simply explaining CAR-T adverse events.


What are the risks and benefits of CAR-T Therapy?

CAR-T (Chimeric Antigen Receptor T-cell) therapy is a form of immunotherapy that involves modifying a patient’s own T cells to recognize and attack cancer cells. While CAR-T therapy has shown remarkable success in treating certain types of cancer, it also comes with risks and potential side effects. Here are some of the risks and benefits associated with CAR-T therapy:

Benefits:

  1. High Response Rates: CAR-T therapy has demonstrated high response rates, especially in certain types of blood cancers, such as lymphomas and leukemia. Many patients who did not respond well to traditional treatments have experienced significant improvement with CAR-T therapy.
  2. Long-lasting Effects: The effects of CAR-T therapy can be long-lasting, with some patients achieving durable remissions. This is particularly promising in comparison to some other cancer treatments that may only provide temporary relief.
  3. Personalized Treatment: CAR-T therapy is often customized for each patient. The patient’s own T cells are extracted, genetically modified, and then infused back into the patient. This personalized approach enhances the specificity of the treatment and reduces the risk of rejection.
  4. Potential for Targeting Solid Tumors: While CAR-T therapy has initially been successful in treating blood cancers, ongoing research is exploring its application for solid tumors. If successful, CAR-T therapy could expand its reach to a broader range of cancers.

Risks:

  1. Cytokine Release Syndrome (CRS): One of the most significant risks associated with CAR-T therapy is CRS, a severe immune reaction that can lead to symptoms such as fever, low blood pressure, and organ dysfunction. In some cases, CRS can be life-threatening.
  2. Neurological Toxicities: Some patients may experience neurological side effects, such as confusion, seizures, or other central nervous system complications. These can be serious and require close monitoring.
  3. On-target, Off-tumor Effects: CAR-T cells are designed to target specific proteins on cancer cells, but there is a risk of unintentionally targeting normal cells that express the same proteins, leading to off-target effects.
  4. Duration of Response: While many patients experience long-lasting remissions, the durability of the response to CAR-T therapy is not guaranteed for all patients. Some may experience relapses, and the long-term effects of the treatment are still being studied.
  5. Manufacturing Challenges: The process of isolating, modifying, and expanding T cells for CAR-T therapy is complex and may not be successful for all patients. Manufacturing challenges can affect the availability and accessibility of the treatment.
  6. Cost and Accessibility: CAR-T therapy is an expensive treatment, and accessibility may be limited due to cost and logistical challenges. This raises concerns about equitable access to this innovative therapy.

Are you a MM survivor who is considering CAR-T therapy? If you’d like to learn more about evidence-based non-conventional therapies let me know- David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Incidence of Secondary T-Cell Malignancies Following CAR T-Cell Therapy

“Investigators have found that second primary malignancies following chimeric antigen receptor (CAR) T-cell therapy were reported in 4.3% of CAR T-cell therapy adverse event reports submitted to the U.S. Food and Drug Administration’s (FDA) Adverse Event Reporting System…

Conclusions

Although the investigators uncovered second primary malignancies in the FDA’s Adverse Event Reporting System, they were unable to establish causation based on the data provided by the agency. According to the American Cancer Society, patients undergoing cancer treatment may face an elevated risk of developing secondary malignancies as a result of several common treatments, including chemotherapy and radiation.

“Patients receiving CAR T-cell therapy are often heavily pretreated with other drugs, which can also contribute to the development of secondary [malignancies],” explained Marcela Maus, MD, PhD, an attending physician at Massachusetts General Hospital. “At this point, the risk of secondary [malignancies] after CAR T-cell therapy cannot be definitively attributed to the CAR T cells, [since] all of these patients received multiple prior chemotherapy agents that are known to elevate the risk of secondary [malignancies],” she underscored.

The investigators indicated that because the Adverse Event Reporting System relies on voluntary reporting of adverse events, duplicate submissions from providers, patients, and manufacturers may have occurred. Additionally, the lack of data on the total number of CAR T-cell therapies prescribed may have made it challenging to estimate the incidence of adverse events such as second primary malignancies across all CAR T-cell therapy use.

CAR T-Cell Therapy for Patients with Multiple Myeloma: Current Evidence and Challenges

“A meta-analysis of the KarMMa and LEGEND-2 trials revealed up to 80% of patients experience CRS, with 14.1% experiencing grade 3 toxicities or higher with a median duration of 7 days for bb2121 and 9 days for LCAR-B38M. The rates and severity of CRS correlate with the dose of infused CAR T-cells.

Current concepts in the diagnosis and management of cytokine release syndrome

“Potentially life-threatening complications of CRS include cardiac dysfunction, adult respiratory distress syndrome, neurologic toxicity, renal and/or hepatic failure, and disseminated intravascular coagulation…

Of particular concern is cardiac dysfunction, which can be rapid onset and severe, but is typically reversible. The pathophysiology of acute cardiac toxicity in the setting of CRS is not clear, but resembles cardiomyopathy associated with sepsis and stress cardiomyopathy, also called Takotsubo cardiomyopathy. Neurologic symptoms occurring in the context of CRS are varied (Table 1) and may occur coincident with other symptoms of CRS or may arise when the other symptoms of CRS are resolving (case 3)…”

Leave a Comment: