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CAR-T Therapy Roadblocks

A MyMyelomaTeam Member asked a question 💭
Atlantic Mine, MI

Can anyone tell me what it takes to get through the criteria for being eligible for CAR-T. What constitutes 1 "line of treatment" and how sick must I get to move on to the next one? Can side effects I don't want to live with disqualify a "line of treatment" or must I show worsening symptoms/labs? Currently we are required to have 4 lines fail and try at least 1 drug each from a list of 3 kinds (IMiD, proteosome inhibitor and anti-CD38 antibody) but CAR-T still looks like your best chance to get… read more

February 3 (edited)
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A MyMyelomaTeam Member

CAR-T cell therapy for multiple myeloma, while promising, does have some roadblocks:

1. Side Effects:
- Cytokine Release Syndrome (CRS): A potentially dangerous side effect experienced by about 85% of patients. Symptoms include fever, low blood pressure, difficulty breathing, and impaired organ function.

2 Show Full Answer

CAR-T cell therapy for multiple myeloma, while promising, does have some roadblocks:

1. Side Effects:
- Cytokine Release Syndrome (CRS): A potentially dangerous side effect experienced by about 85% of patients. Symptoms include fever, low blood pressure, difficulty breathing, and impaired organ function.

2. Eligibility:
- Patients need to have refractory or relapsed myeloma and must have tried at least four other treatments, including immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies.

3. Complex Process:
- The therapy involves collecting T cells, genetically modifying them, and then growing them in the lab, which can take up to three weeks.

4. Pre-Treatment:
- Patients often undergo lymphodepletion (a round of chemotherapy) to make room for the new T cells.

5. Long-Term Monitoring:
- Continuous monitoring is required to manage and mitigate side effects and to assess the long-term effectiveness of the therapy.

These factors can make CAR-T cell therapy challenging for some patients.

August 1
A MyMyelomaTeam Member

Samar I'm really sorry to hear your transplant didn't work, that is rough news. I am so hopeful for CAR-T, this disease is a waking nightmare and I am hating how many terrible drugs they make us take before getting to the only therapy that really seems to have long term hope to be done with that. Best of luck to you.

February 5
A MyMyelomaTeam Member

my transplant last only 6 months ,my m spike start rising again now, car t cell maybe in the future

February 4
A MyMyelomaTeam Member

Thanks Samar for your info. So your Dr. is counting the chemo you had before your stem cell transplant as a line of therapy and the transplant as a seperate line. You have had way more variety of drugs already than I have. I started with VRd like you, but had to stop Revlimid due to severe allergic reaction. It was replaced with Cytoxin which is non specific and doesn't count. I believe I will have to try Darzalex to meet the Anti-CD38 requirement and perhaps Pomalyst as an IMiD because I was so allergic to Revlimid. I hated dexamethasone and wish I could avoid anymore of that one. Carfilzomib sounds like a nightmare too but I think I have done enough Proteosome Inhibitor with all the Velcade I have had so maybe not that one either.
Will you go for the CAR-T? What are you on after transplant and how successful was it?

February 4 (edited)
A MyMyelomaTeam Member

I read that out of (Phone number can only be seen by the question and answer creators) eligible only 10 received it. It also may cause other cancers.

February 4

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