Journal of Medical Case Reports | |
Five-year remission without disease progression in a patient with relapsed/refractory multiple myeloma with extramedullary disease treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2study: a case report | |
Case Report | |
Ai-Li He1  Wan-Hong Zhao2  Yin-Xia Chen2  Yi-Lin Zhang2  Bo Lei2  Xing-Mei Cao2  Yun Yang2  Wang-Gang Zhang2  Jian-Li Wang2  Ju Bai2  Li-Li Wei2  Peng-Yu Zhang2  Xu-Geng Wang2  Jie Liu2  Liu-Fang Gu2  Rui-Li Zhang2  Bai-Yan Wang2  Yan Xu2  Frank Fan3  Qiu-Chuan Zhuang3  Fang-Xia Wang4  | |
[1] Department of Hematology and National-Local Joint Engineering Research Center of Biodiagnostics & Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China;Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, 710004, Xi’an, China;Nanjing Legend Biotech, Nanjing, China;The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China; | |
关键词: Multiple myeloma; CAR-T; BCMA; Case study; Extramedullary disease; | |
DOI : 10.1186/s13256-022-03636-9 | |
received in 2021-07-13, accepted in 2022-10-04, 发布年份 2022 | |
来源: Springer | |
【 摘 要 】
BackgroundMultiple myeloma remains incurable despite treatment advancements over the last 20 years. LCAR-B38M Cells in Treating Relapsed/Refractory Multiple Myeloma was a phase 1, first-in-human, investigator-initiated study in relapsed/refractory multiple myeloma conducted at four sites in China. The study used LCAR-B38M chimeric antigen receptor-T cells expressing two B-cell maturation antigen-targeting single-domain antibodies designed to confer avidity, and a CD3ζ signaling domain with a 4-1BB costimulatory domain to optimize T-cell activation and proliferation. This chimeric antigen receptor construct is identical to ciltacabtagene autoleucel. In the LEGEND-2 study (n = 57, Xi’an site), overall response rate was 88%; median (95% CI) progression-free survival and overall survival were 19.9 (9.6–31.0) and 36.1 (26.4–not evaluable) months, respectively; and median follow-up was 25 months. This case study reports on a patient with relapsed/refractory multiple myeloma (λ light chain type) who was treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study (Xi’an site); he had received five prior lines of treatment and had extensive extramedullary lesions.Case presentationThe patient, a 56-year-old Asian male, received cyclophosphamide (500 mg daily × 3 days) as lymphodepletion therapy and a total dose of 0.5 × 106 chimeric antigen receptor + T cells/kg split into three infusions (days 1, 24, and 84 from June to August 2016). He experienced grade 2 cytokine release syndrome after the first infusion; all symptoms resolved with treatment. No cytokine release syndrome occurred following the second and third infusions. His λ light chain levels decreased and normalized 20 days after the first infusion, and extramedullary lesions were healed as of January 2018. He has sustained remission for 5 years and received no other multiple myeloma treatments after LCAR-B38M chimeric antigen receptor T cell infusion. As of 30 October 2020, the patient is still progression-free and has maintained minimal residual disease-negative (10–4) complete response status for 52 months.ConclusionsThis case provides support that treatment with LCAR-B38M chimeric antigen receptor T cells can result in long-term disease remission of 5 or more years without disease progression in a heavily pretreated patient with extensive extramedullary disease and no other treatment options.
【 授权许可】
CC BY
© The Author(s) 2022
【 预 览 】
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【 参考文献 】
- [1]
- [2]
- [3]
- [4]
- [5]
- [6]
- [7]
- [8]
- [9]
- [10]
- [11]
- [12]
- [13]
- [14]
- [15]
- [16]
- [17]
- [18]
- [19]
- [20]
- [21]
- [22]
- [23]
- [24]
- [25]
- [26]
- [27]
- [28]
- [29]
- [30]