Drug Resistance Research

James Ignatz-Hoover, MD, PhD, hematologist/oncologist, University Hospitals Seidman Cancer Center, and his team of researchers are examining the sequencing of CAR T-cell therapy and bispecific antibodies in the treatment of patients with relapsed/refractory multiple myeloma. Dr. Ignatz-Hoover notes that both CAR T-cell therapies, ciltacabtagene autoleucel (cilta-cel; Carvykti) and idecabtagene vicleucel (ide-cel; Abecma), have demonstrated deep responses in patients with relapsed/refractory multiple myeloma. Both agents were previously approved by the FDA for the treatment of patients with relapsed/refractory multiple myeloma following 4 or more prior lines of therapy, including a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 monoclonal antibody. Notably, the BCMA-directed bispecific antibodies teclistamab-cqyv (Tecvayli) and elranatamab-bcmm (Elrexfio) are both approved in the same indication. Notably, on April 5, 2024, the FDA expanded the indication for cilta-cel to include the treatment of adult patients with relapsed/refractory multiple myeloma who have received at least 1 prior line of therapy, including a PI and an IMiD, and who are refractory to lenalidomide (Revlimid). On the same day, the FDA expanded the indication of ide-cel to include the treatment of adult patients with relapsed/refractory multiple myeloma after 2 or more prior lines of therapy, including an IMiD, PI, and anti-CD38 monoclonal antibody.