Cancer; Discovery

Multiple myeloma care: Taking CAR T-cell therapy for rare blood cancer to the next level

Chimeric antigen receptor (CAR) T-cell therapy is a form of immunotherapy that uses the body’s own immune T-cells to target cancer cells, similar to how the body fights other infections.

Earlier in 2021, the U.S. Food and Drug Administration (FDA) approved CAR T-cell therapy, a personalized form of immunotherapy, as a treatment option for some patients with multiple myeloma – a blood cancer that accumulates in the bone marrow.

Specifically, the therapy was authorized for patients who had not responded to at least four previous different combinations of traditional treatment, such as chemotherapy and immunotherapy.

UT Southwestern was one of just nine U.S. hospitals participating in a 2018 clinical trial for the CAR-T cell therapy idecabtagene vicleucel (brand name Abecma), which more than triples the expected length of remission for patients whose multiple myeloma has relapsed several times.

Our T-cells that typically fight infection, starts decreasing or stops working as cancer develops. With CAR T-cell therapy, we draw a sample of the patient’s blood to access their T-cells. We modify the T-cells with the chimeric antigen receptor (CAR), which binds to specific proteins on cancer cells. Then we infuse the patient’s T-cells back into their blood, where the enhanced cells begin to recognize and attack the cancer.

I clearly remember our team’s excitement when we infused our first patient with potentially lifesaving CAR-T cell therapy. Now that anticipation has come full circle – and the next chapter of work is just beginning.

Despite phenomenal advancements in adult and pediatric research, we still have not achieved a cure for all patients with multiple myeloma, an aggressive cancer that attacks plasma cells, which are essential to the body’s immune system. CAR-T cell therapy is not available or effective for every patient yet, and traditional treatments can weaken the immune system.

My colleague, Alec Zhang, Ph.D., and I have received a grant through the Leukemia & Lymphoma Society to develop novel immunotherapy for patients with blood cancer, specifically multiple myeloma.

Through our research, Dr. Zhang and I hope to identify treatments that are novel strategies at killing multiple myeloma cells and also augment the effectiveness of current therapies.

Bringing new treatments from the lab to patients

Translating research findings into direct patient benefits is at the heart of what we do at UT Southwestern. Here are just a few examples of recent bench-to-bedside approaches that have led to key advancements in cancer care:

UTSW was instrumental in the research that led to FDA approval of tisagenlecleucel (Kymriah) to treat patients with acute lymphoblastic leukemia (ALL) whose disease has returned or is resistant to other treatments. ALL is the most common type of pediatric leukemia.

  • We are one of 25 sites for the Novartis-sponsored ELIANA study – the first global clinical trial of CAR T-cell therapy for the treatment of refractory and relapsed pediatric ALL.
  • We are leading research into CAR T-cell therapy for pediatric acute myeloid leukemia (AML), which researchers hope to move into clinical trials in the near future.

Related reading: CAR T-cell therapy experts push boundaries of pediatric cancer treatment

Improving current treatments – and making new combinations

Not every multiple myeloma treatment works for every patient. However, some drugs may be more effective when used in combination. UT Southwestern is involved in a study, Myeloma-Developing Regimens Using Genomics (MyDRUG), to determine whether adding medications to existing drug combinations – or creating new combinations – could make current drugs work better for more patients.

In creating new combinations, we will focus on stopping cancer growth at its source. Cancer cells need nutrition to live and grow. If you cut off a path of their nutrition, the cancer cell dies. We want to determine whether novel medications can target and shut down different feeding paths to attack cancer cells in a new way.

Personalized medicine for each patient

As an academic medical center, UT Southwestern offers clinical trials in which patients can access treatment options that may not be widely available. We can customize precise treatments to each patient and their type of cancer. Then, when we have exhausted traditional therapies, we can bring in outside-the-box options such as drugs that are available through clinical trials.

Because our teams are heavily involved in developing advanced cancer treatments, we often are ahead of the curve when these drugs are approved by the FDA. Our multidisciplinary cancer team – oncologists, nurses, psychiatrists, dietitians, pharmacists, and other specialists – is always brainstorming the next best way to improve cancer treatment.

It’s exciting to think how far we’ve come with CAR T-cell therapy in just a few short years. It’s always amazing to hear from multiple myeloma patients who had exhausted traditional treatments before they started in our clinical trial tell me they now feel like they never had myeloma.

We look forward to building on what we have learned to continue helping ever more patients battle cancer.

To find out if you or a loved one might benefit from CAR T-cell therapy, call 214-645-8300 or request an appointment online.