Controlling CRS-related coagulopathy improves the safety of CAR T-cell therapy for MM

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Published: 20 Jun 2019
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Dr Heng Mei - Huazhong University of Science and Technology, Wuhan, China

Dr Heng Mei speaks to ecancer at the 2019 European Hematology Association (EHA) Annual Meeting about improving the safety of CAR T-cell therapy by controlling CRS-related coagulopathy.

He reports that the phase I study found that early and proper interventions targeted at CRS-related coagulopathy are important in controlling side effects with the therapy.

Dr Mei says that the next steps for the study are to include more patients and to do multiple-centre research, potentially with collaborators from Europe.

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

This year I bring our latest research about multiple myeloma. It’s about CAR T-cell therapy for relapsed or refractory multiple myeloma. As we well know, multiple myeloma is a very common disease in Western countries, the incidence is about 3-10 per 100,000 each year. Despite many methods that have been developed in recent years, including immunological therapies and other therapies, but still it is incurable. So r/r MM is very challenging for clinicians.

Our group designed a new CAR T therapy for multiple myeloma. The target we use is CD38 and BCMA. I think this is the first new CAR T for multiple myeloma in the world so we used this therapy from 2018 and to the end of last year we had finished 14 patients. For this half year we have finished 12 patients. So the results show that the ORR is above 83%, it’s very high. Interestingly, included in this half of them reached sCR. So what does that mean? It means these patients will reach a deep CR with a longer time for disease free lapse. So that’s an excellent result.

Another thing you might ask me is about the side effects for that. The results were also very good. We did have some CRS but only one third of the CRS reached above grade 3, most was below, 1 and 2, and it had been obviously controlled and compared to ALL and HAL there is no CRS happening in our assay. So it’s very safe.

So this is a phase I study so after that we want to promote more patients, include more patients, and do some multiple centre research. Maybe we want some collaborators from Europe, then we can develop this new CAR T for r/r MM in the future.

What are some of the challenges of treating multiple myeloma in China?

Multiple myeloma is not the most common haematological malignancy in China, it is rank 3 or 4. But with the development of the economy it is more and more common now and it is an ageing world region I think there will be more patients.

For multiple myeloma in Western countries there are many different new medications including monoclonal antibodies and some proteasome and different generations for that but it’s not very easy to get in China. So for the new drugs may be sometimes developed in the US or Europe and then imported to China so these patients cannot reach that. But for China we have a great job in CAR T-cell therapy. There are 58 CAR T registered clinical trials for multiple myeloma in the world and half are in China. So I think that is good for r/r MM patients in China.