CAR-T Cell Therapy vs Stem Cell Transplant for the Treatment of Patients With Multiple Myeloma

During a debate at the 2023 Lymphoma, Leukemia & Myeloma Congress in New York, New York, Adriana Rossi, MD, Mount Sinai, New York, New York, debated whether CAR-T therapy is more beneficial than stem cell transplant as consolidation therapy among patients with multiple myeloma.

Transcript:

My name is Adriana Rossi. I'm one of the co-directors of [the] CAR-T and Cellular Therapy Program at the Myeloma Center at Mount Sinai here in New York. It was my great pleasure to be here at the Lymphoma, Leukemia, & Myeloma meeting and debate Dr. Sergio Giralt on the role of transplant versus CAR-T, and are we ready to have CAR-T replace stem cell transplants? 

It is early days. There's not a lot of data, but I think we had a really good review of everything that is known and all the things that we're looking forward to, that is, data that is coming our way. Stem cell transplants still have a place. I will concede that we don't need to do away with them entirely, but I am very hopeful that we, in the coming years, won't need to put patients through such high dose melphalan with all the associated toxicities and detriments in quality of life. I don't know if replacing [them] or maybe using them together and really tailoring it to the patient. So having a patient-directed plan, using some [or] all the different tools that we have, is really a very blessed place to be in myeloma therapy today. 

We have an abundance of options, and with the early data for CARTITUDE-4, hopefully moving CAR-T to earlier lines in the commercial space soon may give us some of that information. We did review that CARTITUDE-6 is an ongoing study where we will have head-to-head comparison of CAR-T and stem cell transplants for patients with myeloma. And once that reads out, maybe we can put some of these debates to rest. 

Given that currently the 2 approved commercial CAR-T cell therapies are both BCMA targeting and are both autologous, I am looking forward to, in the coming months and years, having data on allogeneic products that could really divert some of the manufacturing problems and different types of constructs that we can then use as well. So [it is] early days for CAR-T, but very, very hopeful that they will, at least soon, replace stem cell transplant.

Source:

Rossi A. Debate: Management of a Fit Patient: Should CAR-T Replace Autotransplant as Consolidation? Presented at Lymphoma, Leukemia & Myeloma Congress; October 18-21, 2023. New York, NY