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.