Failure of CAR-T cell therapy in relapsed and refractory large cell lymphoma and multiple myeloma: An urgent unmet need

Blood Rev. 2023 Jul:60:101095. doi: 10.1016/j.blre.2023.101095. Epub 2023 Apr 29.

Abstract

Since its FDA approval, chimeric antigen receptor (CAR)-T cell therapy is changing the landscape of the treatment algorithm for relapsed and refractory large cell lymphoma and multiple myeloma. While initially hailed as a game changer and received widely with great enthusiasm, the reality of treatment failure soon became a major disappointment. This situation left patients and clinicians alike wondering about the next treatment options. CAR-T cell therapy failure for aggressive lymphoma or multiple myeloma creates a very poor prognosis and the treatment options are very limited. New emerging data, however, show promise for the use of approaches that include bispecific antibodies and other strategies to rescue affected patients. In this review, we summarize the current emerging data on the treatment options for patients whose disease has relapsed or remains refractory after CAR-T cell therapy failure, an area of great unmet need.

Trial registration: ClinicalTrials.gov NCT04586426.

Keywords: Antibody drug conjugates; Bispecific T-cell engagers; CAR-T cell therapy; Checkpoint inhibitors; Hematopoietic cell transplantation; Relapsed/refractory lymphoma; Relapsed/refractory multiple myeloma.

Publication types

  • Review

MeSH terms

  • Cell- and Tissue-Based Therapy
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Lymphoma, Non-Hodgkin*
  • Multiple Myeloma* / pathology
  • Multiple Myeloma* / therapy
  • Receptors, Chimeric Antigen*
  • T-Lymphocytes

Substances

  • Receptors, Chimeric Antigen

Associated data

  • ClinicalTrials.gov/NCT04586426