Clinical Outcomes of BCMA CAR-T Cells in a Multiple Myeloma Patient With Central Nervous System Invasion

Frontiers in Oncology

Bing Bu¹  Xin-an Lu¹  Lie Ma¹  Fei Wu²  Yueming Shan²  Ting He²  Ru Feng³  Ting Wang⁴  Yanping Ding⁴  Feifei Qi⁴  Yazi Yang⁵  Hui Liu⁵ 

[1] Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China;National Center of Gerontology;China Medical University, Shenyang, China;Department of Hematology, Beijing Hospital;Immunochina Pharmaceuticals Co., Ltd., Beijing, China;

关键词: CAR-T;    BCMA;    multiple myeloma;    central nervous system;    case report;   

DOI  :  10.3389/fonc.2022.854448

来源: DOAJ

【 摘 要 】

BackgroundMultiple myeloma (MM) is the second most common hematological malignancy that still lacks effective clinical treatments. In particular, MM with central nervous system (CNS) invasion occurs rarely. Although B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor-T (CAR-T) cell therapy has shown great promise for the treatment of relapsed/refractory MM, few studies have reported whether BCMA CAR-T could inhibit MM with CNS invasion.Case PresentationIn this study, we report a special case of a 63-year-old male patient who suffered MM with CNS invasion and presented rapid extramedullary disease (EMD) progression into multiple organs. Before CAR-T cell infusion, this patient received five cycles of bortezomib, Adriamycin, and dexamethasone (PAD) and an autologous transplant as the front-line treatment, followed by two cycles of bortezomib, lenalidomide, and dexamethasone (VRD) as the second-line regimen, and daratumumab, bortezomib, dexamethasone (DVD) as the third-line regimen. Since the patient still showed rapid progressive disease (PD), BCMA CAR-T cells were infused, and 1 month later, a stringent complete response (sCR) was achieved, and the response lasted for 4 months. Meanwhile, only grade 1 cytokine release syndrome (CRS) was observed.ConclusionThis case report demonstrated that BCMA CAR-T could effectively eradicate CNS-involved MM with low adverse events, suggesting that CAR-T cell therapy could be a feasible therapeutic option for this kind of refractory disease.Clinical Trial Registrationhttps://ClinicalTrials.gov, identifier: NCT04537442.a

【 授权许可】

Unknown