C. Ola Landgren, MD, PhD, chief of Myeloma Service and hematologic oncologist at Memorial Sloan Kettering Cancer Center, discusses what is next for chimeric antigen receptor (CAR) T-cell therapy in the multiple myeloma landscape.
Landgren thinks the field is about to reach its potential since there are several CAR T cells that are autologous; these are going after the same target, so remaining questions now include which agent be the winner or will there be room for multiple CAR T therapies? The upcoming data will show what is best for patients with multiple myeloma. It may depend on which therapy is easier to give, which could be given in the outpatient setting, and which is safer. He says if there is a difference in efficacy, that would also generate an answer as to which agent is best, but right now it is uncertain.
There are also specific antibodies in development at the same time as these CAR T-cell therapies are being researched. For patients with multiple myeloma, there are many bi-specific antibodies being investigated. There are 5 to 10 of them right now that go after BCMA and CD3, and there are also tri-specific antibodies in development that have co-stimulatory domains, according to Landgren. CAR T cells and the bi-specific therapies are both quickly moving forward, as well as possible tri-specifics. He says the winner will be a combination, but the future will tell.