Chimeric antigen receptor T-cell therapy for multiple myeloma.

PURPOSE OF REVIEW: Chimeric antigen receptor T-cell therapy (CAR T) in relapsed, refractory multiple myeloma (RRMM) has rapidly expanded with two FDA-approved agents and many more in the clinical trial pipeline. As such, we aim to review the standard of care and investigational products.

RECENT FINDINGS: Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) were initially approved in the fourth-line setting and quickly moved to the second-line and third-line settings due to efficacy. Delayed neurotoxicities remain a challenging entity to consider when deciding on CAR T versus other options. Given the high efficacy of cilta-cel, many trials are evaluating its role as frontline consolidation or even in smoldering myeloma. Many novel CAR T products are being studied and will improve the impressive armamentarium of RRMM therapeutics.

SUMMARY: This is an exciting area with countless studies investigating novel CAR T constructs and sequencing in hopes of further extending and improving our patients' lives.