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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.
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REMS for CAR-T Myeloma
If you are wondering why the FDA removed REMS for CAR-T for Myeloma, first ask yourself why Risk Evaluation and Mitigation Strategies for Autologous Chimeric Antigen Receptor CAR-T cell immunotherapies were needed in the first place.
The simple answer to this question is that CAR-T therapy comes with serious short-term, long-term, and late-stage side effects. Your thought then is that you’ve been dealing with side effects ever since you began MM therapy, and that you may be running out of therapy options…so what choice do I have?
The video of Wendy H. Vogel, RN, MSN, FNP, below is interesting because Wendy discusses the REMS for thalidomide and Revlimid. Two older MM therapies that you might consider relatively harmless.
My point is not that chemotherapy regimens have serious side effects. My thinking is that conventional oncology does not study non-conventional therapies that have been shown to mitigate some side effects.
For example, curcumin has been shown to enhance the efficacy of Revlimid.
REMS 101: Risk Evaluation Mitigation Strategies – Wendy H. Vogel, RN, MSN, FNP
I did, however, learn that oncologists do a lousy job of educating MM patients about possible side effects and what to look for. And I have discovered dozens of evidence-based but non-conventional therapies to mitigate side effects that oncologists dismiss out of hand.
The bottom line? Buyer beware. Meaning, MM survivors who are considering CAR-T therapy, you are on your own when it comes to learning about the short-term, long-term, and late-stage side effects that can come with CAR-T cell therapy.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about managing your MM with conventional and non-conventional therapies.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
FDA Eliminates Risk Evaluation and Mitigation Strategies (REMS) for Autologous Chimeric Antigen Receptor CAR T cell Immunotherapies
The U.S. Food and Drug Administration announced today that it has eliminated the Risk Evaluation and Mitigation Strategies (REMS) for currently approved BCMA- and CD19-directed autologous chimeric antigen receptor CAR T cell immunotherapies.
These products are gene therapies that are currently approved to treat blood cancers, such as multiple myeloma and certain types of leukemia and lymphoma.
“The FDA has taken the bold step to remove the Risk Evaluation and Mitigation Strategy requirement from giving CAR T therapies. REMS is a useful safety system, but reevaluation over time helps inform whether a REMS is still needed to ensure that the benefits of a product outweigh its risks,” said FDA Vinay Prasad, M.D., M.P.H., Chief Medical and Scientific Officer and Director, Center for Biologics Evaluation and Research. “Eliminating the REMS that is no longer needed also expedites the delivery of potentially curative treatments to patients and reduces burden on providers.”
A REMS is a safety program that the FDA can require for certain medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks.
The FDA determined that the approved REMS for the following products should be eliminated because a REMS is no longer necessary to ensure that the benefits of the autologous CAR T cell immunotherapies outweigh their risks.
- Abecma (idecabtagene vicleucel)
- Breyanzi (lisocabtagene maraleucel)
- Carvykti (ciltacabtagene autoleucel)
- Kymriah (tisagenlecleucel)
- Tecartus (brexucabtagene autoleucel)
- Yescarta (axicabtagene ciloleucel)
The elimination of REMS for the above products removes the requirements that hospitals and their associated clinics that dispense products must be specially certified and have on-site, immediate access to tocilizumab. The information regarding the risks for these CAR T cell immunotherapies can be conveyed adequately via the current product labeling, which includes a boxed warning for the risks of cytokine release syndrome and neurological toxicities, and medication guides.
“Physicians and institutions now have greater experience identifying and managing toxicities with the currently approved CAR T products,” said Richard Pazdur, M.D., FDA Oncology Center of Excellence Director. “This approach will potentially facilitate patient access to these treatments while continuing to prioritize safety.”
Continuous monitoring and assessment of the safety of all biological products, including the CAR T cell immunotherapies, is an FDA priority and we remain committed to informing the public when we learn new information about these products.
These products will continue to be subject to safety monitoring, through adverse event reporting requirements in accordance with regulations (21 CFR 600.80). The elimination of the REMS for these products does not change FDA requirements for manufacturers to conduct post marketing observational safety studies to assess the risk of secondary malignancies and long-term safety with follow up of patients for 15 years after product administration.
REMS for CAR-T for Myeloma REMS for CAR-T for Myeloma REMS for CAR-T for Myeloma