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The 24th National Conference on Clinical Oncology and the 2021 CSCO Academic Annual Conference will be held on September 25-29, 2021.
At this conference, Professor Deng Qi from the Department of Hematology, Tianjin First Central Hospital stated that -The efficacy of T cell therapy in patients with relapsed/refractory multiple myeloma with and without extramedullary lesions" was reported on the topic
.
On this occasion, Yimaitong invited Professor Deng Qi to accept an interview to share the progress of the treatment of extramedullary multiple myeloma (EMM)
.
Yimaitong: Could you please briefly introduce the current status of EMM treatment? Professor Qi Deng EMM is a rare type of multiple myeloma (MM), which is an extremely high-risk type of MM.
It can occur when MM is first diagnosed or in the relapse and refractory stage of MM.
The prognosis is extremely poor.
EMM patients Survival time is greatly shortened
.
In addition, EMM is divided into simple bone-related extramedullary lesions and soft tissue-related extramedullary lesions.
Studies have found that compared with simple bone-related extramedullary lesions, patients with soft tissue-related extramedullary lesions have a worse prognosis
.
At present, the era of new drugs still cannot reverse the poor prognosis of EMM, and even hematopoietic stem cell transplantation cannot enable patients to survive longer, and it is still necessary to explore new treatment methods
.
Yimaitong: Could you please introduce the results and significance of the targeted BCMA CAR-T cell therapy for patients with relapsed and refractory MM (R/R MM) with and without extramedullary disease? Professor Deng Qi has achieved very good efficacy in targeting BCMA CAR-T cells to treat R/R MM, but there are limited data on the long-term efficacy and safety of targeted BCMA CAR-T cells in the treatment of EMM patients
.
Our center has cooperated with related companies to explore the differences in efficacy (short-term efficacy and long-term efficacy) and safety of fully humanized BCMA CAR-T cells in the treatment of EMM patients and R/R MM patients without extramedullary disease
.
There were 7 cases in the EMM group and 13 cases in the R/R MM group without extramedullary lesions
.
There was no difference in baseline levels except for extramedullary lesions .
The results showed that the overall response rate (ORR) of the two groups of patients was the same, and there was no statistical difference; the 180-day progression-free survival (PFS) rate and the overall survival (OS) rate of the two groups were the same, and there was no statistical difference, but EMM patients The 360-day PFS rate and OS rate are lower than those of R/R MM patients without extramedullary disease (as shown in the figure below)
.
Among patients with ORR, cytokine release syndrome (CRS) and immune effector cell-related neurotoxic syndrome (ICANS) in EMM patients are higher than those in R/R MM patients without extramedullary disease
.
The results indicate that fully humanized BCMA CAR-T cell therapy provides a new treatment for EMM patients, and EMM patients can benefit from targeted BCMA CAR-T cell therapy in the short term
.
After remission is achieved, is it possible to combine other MM treatments (such as radiotherapy, hematopoietic stem cell transplantation, new drug therapy [such as pomalidomide, CD38 monoclonal antibody], etc.
) for maintenance treatment? Can it continue after 180 days? A good state of relief still needs more exploration
.
Yimaitong: What are your expectations for the future targeted BCMA treatment of MM? What are your prospects for the treatment of EMM? Professor Deng Qi’s targeted BCMA CAR-T therapy started from the mouse BCMA target, and has achieved good curative effects.
After that, the fully humanized CAR-T cells have higher affinity to tumor cells and have more killing activity.
Strong, while improving the efficacy, it will also bring greater side effects
.
Under this circumstance, I hope to combine various drugs with CAR-T cell therapy.
For example, first apply other drug therapy to reduce tumor burden, and then bridge CAR-T cell therapy.
In this way, CAR-T cell therapy It can not only play a very good curative effect, but also reduce toxic and side effects, so that patients can benefit more safely
.
For the treatment of EMM patients, I think that one is to hope that more new drugs will be produced, and the other is to explore multi-target CAR-T cell therapy, such as the BCMA target that has achieved good curative effects (of course, its long-term efficacy and curative effect) The persistence of the drug remains to be further improved and explored) in combination with the GPRC5D target highly expressed on myeloma cells, or in combination with other targets
.
Whether these programs can enable MM patients, especially EMM patients, to achieve a longer survival period, I think it remains to be clinically explored
.
Professor Deng Qi, Chief Physician of the Department of Hematology, Tianjin First Central Hospital, member of the Standing Committee of Tianjin Medical Association Tianjin Branch, Tianjin Medical and Health Association Member of the Standing Committee of the Hematology Branch of Tianjin Medical Health Association Member of the Standing Committee of Hematology Branch of Tianjin Medical Association, Member of the Standing Committee of Hematology Branch of Tianjin Medical Association Member of the Standing Committee of Tianjin Hematology Branch of Integrated Western Medicine Member of China Society of Immunobiotechnology Member of Tianjin Branch of China Anti-Cancer Association Member of Infectious Disease Professional Committee of China Medical Education Association
At this conference, Professor Deng Qi from the Department of Hematology, Tianjin First Central Hospital stated that -The efficacy of T cell therapy in patients with relapsed/refractory multiple myeloma with and without extramedullary lesions" was reported on the topic
.
On this occasion, Yimaitong invited Professor Deng Qi to accept an interview to share the progress of the treatment of extramedullary multiple myeloma (EMM)
.
Yimaitong: Could you please briefly introduce the current status of EMM treatment? Professor Qi Deng EMM is a rare type of multiple myeloma (MM), which is an extremely high-risk type of MM.
It can occur when MM is first diagnosed or in the relapse and refractory stage of MM.
The prognosis is extremely poor.
EMM patients Survival time is greatly shortened
.
In addition, EMM is divided into simple bone-related extramedullary lesions and soft tissue-related extramedullary lesions.
Studies have found that compared with simple bone-related extramedullary lesions, patients with soft tissue-related extramedullary lesions have a worse prognosis
.
At present, the era of new drugs still cannot reverse the poor prognosis of EMM, and even hematopoietic stem cell transplantation cannot enable patients to survive longer, and it is still necessary to explore new treatment methods
.
Yimaitong: Could you please introduce the results and significance of the targeted BCMA CAR-T cell therapy for patients with relapsed and refractory MM (R/R MM) with and without extramedullary disease? Professor Deng Qi has achieved very good efficacy in targeting BCMA CAR-T cells to treat R/R MM, but there are limited data on the long-term efficacy and safety of targeted BCMA CAR-T cells in the treatment of EMM patients
.
Our center has cooperated with related companies to explore the differences in efficacy (short-term efficacy and long-term efficacy) and safety of fully humanized BCMA CAR-T cells in the treatment of EMM patients and R/R MM patients without extramedullary disease
.
There were 7 cases in the EMM group and 13 cases in the R/R MM group without extramedullary lesions
.
There was no difference in baseline levels except for extramedullary lesions .
The results showed that the overall response rate (ORR) of the two groups of patients was the same, and there was no statistical difference; the 180-day progression-free survival (PFS) rate and the overall survival (OS) rate of the two groups were the same, and there was no statistical difference, but EMM patients The 360-day PFS rate and OS rate are lower than those of R/R MM patients without extramedullary disease (as shown in the figure below)
.
Among patients with ORR, cytokine release syndrome (CRS) and immune effector cell-related neurotoxic syndrome (ICANS) in EMM patients are higher than those in R/R MM patients without extramedullary disease
.
The results indicate that fully humanized BCMA CAR-T cell therapy provides a new treatment for EMM patients, and EMM patients can benefit from targeted BCMA CAR-T cell therapy in the short term
.
After remission is achieved, is it possible to combine other MM treatments (such as radiotherapy, hematopoietic stem cell transplantation, new drug therapy [such as pomalidomide, CD38 monoclonal antibody], etc.
) for maintenance treatment? Can it continue after 180 days? A good state of relief still needs more exploration
.
Yimaitong: What are your expectations for the future targeted BCMA treatment of MM? What are your prospects for the treatment of EMM? Professor Deng Qi’s targeted BCMA CAR-T therapy started from the mouse BCMA target, and has achieved good curative effects.
After that, the fully humanized CAR-T cells have higher affinity to tumor cells and have more killing activity.
Strong, while improving the efficacy, it will also bring greater side effects
.
Under this circumstance, I hope to combine various drugs with CAR-T cell therapy.
For example, first apply other drug therapy to reduce tumor burden, and then bridge CAR-T cell therapy.
In this way, CAR-T cell therapy It can not only play a very good curative effect, but also reduce toxic and side effects, so that patients can benefit more safely
.
For the treatment of EMM patients, I think that one is to hope that more new drugs will be produced, and the other is to explore multi-target CAR-T cell therapy, such as the BCMA target that has achieved good curative effects (of course, its long-term efficacy and curative effect) The persistence of the drug remains to be further improved and explored) in combination with the GPRC5D target highly expressed on myeloma cells, or in combination with other targets
.
Whether these programs can enable MM patients, especially EMM patients, to achieve a longer survival period, I think it remains to be clinically explored
.
Professor Deng Qi, Chief Physician of the Department of Hematology, Tianjin First Central Hospital, member of the Standing Committee of Tianjin Medical Association Tianjin Branch, Tianjin Medical and Health Association Member of the Standing Committee of the Hematology Branch of Tianjin Medical Health Association Member of the Standing Committee of Hematology Branch of Tianjin Medical Association, Member of the Standing Committee of Hematology Branch of Tianjin Medical Association Member of the Standing Committee of Tianjin Hematology Branch of Integrated Western Medicine Member of China Society of Immunobiotechnology Member of Tianjin Branch of China Anti-Cancer Association Member of Infectious Disease Professional Committee of China Medical Education Association
