Academic model for CAR-T development: ARI0002h for multiple myeloma and beyond
Carlos Fernández de Larrea
Hospital Clínic de Barcelona
Despite recent therapeutic advances, the prognosis of patients with refractory multiple myeloma remains poor. Chimeric antigen receptor (CAR) T-cell therapy has changed the treatment landscape of this disease. Thus, B-cell maturation antigen (BCMA)-targeted CAR T-cells have established outstanding results in heavily pre-treated patients. However, the high demand and expensive costs associated with CAR T-cell therapy might prove unsustainable for health systems. Academic CAR T-cells could potentially overcome these issues. ARI0002h administered in a fractioned manner with a booster dose after 3 months can provide deep and sustained responses in patients with relapsed or refractory multiple myeloma, with a low toxicity, especially in terms of neurological events, and with the possibility of a point-of-care approach. Unfortunately, relapses after CAR T-cell infusion are described. Understanding the underlying mechanisms of resistance is essential to promote prevention strategies and to enhance CAR T-cell efficacy. In this sense, several new strategies are currently under investigation to optimize ARI0002h.