Chimeric antigen receptor (CAR) T-cell therapy has shown promise in patients with late-line refractory multiple myeloma, with response rates ranging from 73 to 98%. To date, three products have been approved: Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), which are approved by the US Food and Drug Administration, the European Medicines Agency, Health Canada (ide-cel only), and Brazil ANVISA (cilta-cel only); and equecabtagene autoleucel (eque-cel), which was approved by the Chinese National Medical Products Administration. CAR T-cell therapy is different from previous anti-myeloma therapeutics with unique toxic effects that require distinct mitigation strategies. Thus, a panel of experts from the International Myeloma Working Group was assembled to provide guidance for clinical use of CAR T-cell therapy in myeloma. This consensus opinion is from experts in the field of haematopoietic cell transplantation, cell therapy, and multiple myeloma therapeutics.

Department of Clinical Therapeutics School of Medicine National and Kapodistrian University of Athens Athens Greece

Department of Haematology Singapore General Hospital Singapore

Department of Hematology Amsterdam University Medical Center Amsterdam Netherlands

Department of Hematology and Oncology University of Chicago Chicago IL USA

Department of Hematology Cancer Center Clinica Universidad de Navarra Pamplona Navarra Spain

Department of Hematology Hospital Clinic de Barcelona IDIBAPS University of Barcelona Barcelona Spain

Department of Hematology Mayo Clinic Rochester MN USA

Department of Hematology Myeloma and Lymphoma Center Shanghai Changzheng Hospital Navy Medical University Shanghai China

Department of Hematology Oncology University of Alabama at Birmingham Birmingham AL USA

Department of Hematology University Hospital of Nantes Nantes France

Department of Hematology University of California San Francisco CA USA

Department of Hematooncology University Hospital Ostrava Ostrava Czech Republic; Department of Hematooncology Faculty of Medicine University Ostrava Ostrava Czech Republic

Department of Internal Medicine 2 University Hospital Wurzburg Germany

Department of Medical Oncology National University Cancer Institute Singapore

Department of Medicine and Department of Haematology National University of Ireland Galway Ireland

Department of Medicine Harvard University Cambridge MA USA

Department of Oncology Hematology and Bone Marrow Transplantation University Medical Center Hamburg Eppendorf Hamburg Germany

Hospital Universitario 12 de Octubre Department of Medicine Complutense University CNIO Madrid Spain

Hospital Universitario de Salamanca Salamanca Spain

Institute of Hematology Royal Prince Alfred Hospital University of Sydney Sydney NSW Australia

Memorial Sloan Kettering Cancer Center New York NY USA

National Clinical Research Center for Blood Diseases and State Key Laboratory of Experimental Hematology Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Pekin Union Medical College Tianjin China

Oslo Myeloma Center Oslo University Hospital Oslo Norway

School of Medicine Stanford University San Francisco CA USA

Simmons Comprehensive Cancer Center Dallas TX USA; University of Texas Southwestern Medical Center Dallas TX USA

Translational Genomics Research Institute City of Hope Cancer Center Phoenix AZ USA

Winship Cancer Institute of Emory University Atlanta GA USA

Lancet Oncol. 2024 Aug;25(8):e336. doi: 10.1016/S1470-2045(24)00337-1. PubMed

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