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Immune Environment May Influence CAR T Response Durability

December 2, 2022

December 2022

Response durability in patients with multiple myeloma (MM) who are treated with chimeric antigen receptor (CAR) T-cell therapy may be affected by the patient’s post-treatment immune environment. Though CAR T-cell therapy has high response rates in this patient population, recurrent disease is common.

Researchers conducted a retrospective study to assess the determinants of durable responses to CAR T-cell therapy in patients with MM. They assessed the proportion of various cells in each patient’s bone marrow sample and analyzed it against progression-free survival (PFS) rates.

Results showed longer PFS in patients “with an increased proportion of CLEC9A+ dendritic cells (DCs), CD27+TCF1+ T cells with diverse T-cell receptors, and emergence of T cells expressing marrow-residence genes.”

On the other hand, shorter PFS was associated with presence of hyperexpanded clones with exhaustion phenotype, BAFF+PD-L1+ myeloid cells in the marrow, and lower diversity among T-cell receptor repertoire pretherapy.

The researchers noted, “These data illustrate a dynamic interplay between endogenous T, CAR-T, myeloid/DC, and tumor compartments that affects the durability of response following CAR T therapy in myeloma.”

Source: Blood Cancer Discovery, August 26, 2022.

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