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.
I am posting Tom’s account for three reasons- first, CAR T-Cell therapy is one of the newest treatments for multiple myeloma (MM). Second, many MMers are intensely interested in learning more about CAR-T cell therapy and three,Tom has done a thorough job of listing all important stages, issues, etc. The information below is Tom’s account, in Tom’s words.
Please keep in mind that the newest treatments for MM change frequently. Research, FDA approval (or not) change the landscape for newest treatments regularly. But this is also the way we want it…
Lastly, Tom gave me an email address for any/all readers to email questions to him.
“All 16 patients who had a response (partial response or better) and who could be evaluated for minimal residual disease (MRD) had MRD-negative status…”
You were diagnosed with multiple myeloma (MM) years ago. Your first remission was the longest and you’ve relapsed twice or three times now and your remissions are getting shorter. You’ve probably been dealing with short, long-term and late stage side effects…for years. You’ve read about CAR-T therapy…
There has been a lot of talk about CAR-T Cell therapy. Based on the studies I’ve read, CAR-T does seem as though this therapy elicits a greater overall response and a longer PFS than does the standard-of-care doublet or even newer triplets.
But at what cost? Side effects and financial cost seem to be serious. Make sure you understand this therapy.
The challenge of the RRMM is to make sense of the alphbet soup of relapsed/refractory multiple myeloma (RRMM) therapies. Is PCD better for you than CAR-T or the standard-of-care? The key is to compare apples to apples and apply what you learn to your specific situation.
“Triplet treatment with the combination of pomalidomide, cyclophosphamide, and dexamethasone (PCD) in patients with relapsed or refractory multiple myeloma (RRMM) who have received at least 2 prior lines of therapy could improve clinical outcomes, according to study results published in the Annals of Hematology…
The overall response rate was 76%, with 27% of patients achieving very good partial response. Median time to best response was 3.6 months.
No patients achieved a complete response. The authors noted this could be because none of the patients who experienced immunofixation underwent bone marrow aspiration, as bone marrow aspiration is rarely performed outside the context of clinical trials…
After a median follow-up of 16 months, median progression-free survival (PFS) was 7.3 months and median overall survival (OS) was not reached.
Nine patients had high-risk cytogenetics, and median PFS was shorter in this group (3.3 months) compared with patients who had standard-risk cytogenetics (7.9 months; P =.0027). OS was similarly shorter in patients with high-risk cytogenetics, at 6.5 months compared with not reached (P =.003).
The most frequent adverse event was hematologic toxicity, with 37% of patients experiencing grade 3 or 4 cytopenia. Adverse events resulted in discontinuation of therapy in 18% of patients.
The authors concluded that treatment with PCD was feasible and cost effective, and that it resulted in improved response rates and PFS compared with doublet pomalidomide and dexamethasone treatment, which is currently the standard of care in this patient population.”
“The phase 3 study enrolled 307 patients in 24 countries with relapsed or refractory multiple myeloma who had received at least two prior therapies. They received either pom-dex alone or pom-dex in tandem with isatuximab.
The isatuximab combo kept cancer at bay for a median of 11.5 months, a five-month improvement over the 6.5 months for pom-dex alone. It also increased the number of patients for whom pom-dex worked—the combo shrank tumors in 60% of patients, compared to 35% for the standard of care alone. What’s more, of the patients who responded to treatment, the isatuximab combo worked faster, taking a median of 35 days to get a response versus 58 days for pom-dex alone…
An analysis showed that the isatuximab combo performed similarly in different subgroups, including the elderly and people with poor kidney function…”
“Preclinical studies suggest that bb2121, a chimeric antigen receptor (CAR) T-cell therapy that targets B-cell maturation antigen (BCMA), has potential for the treatment of multiple myeloma…
Results for the first 33 consecutive patients who received a bb2121 infusion are reported. The data-cutoff date was 6.2 months after the last infusion date.
Hematologic toxic effects were the most common events of grade 3 or higher, including
A total of 25 patients (76%) had cytokine release syndrome, which was of grade 1 or 2 in 23 patients (70%) and grade 3 in 2 patients (6%).
Neurologic toxic effects occurred in 14 patients (42%) and were of grade 1 or 2 in 13 patients (39%). One patient (3%) had a reversible grade 4 neurologic toxic effect.
The objective response rate was 85%, including 15 patients (45%) with complete responses. Six of the 15 patients who had a complete response have had a relapse. The median progression-free survival was 11.8 months (95% confidence interval, 6.2 to 17.8).
All 16 patients who had a response (partial response or better) and who could be evaluated for minimal residual disease (MRD) had MRD-negative status (≤10−4 nucleated cells). CAR T-cell expansion was associated with responses, and CAR T cells persisted up to 1 year after the infusion…
CONCLUSIONS-We report the initial toxicity profile of a BCMA-directed cellular immunotherapy for patients with relapsed or refractory multiple myeloma. Antitumor activity was documented.