Emerging role of CAR T cell therapy in multiple myeloma

Multiple myeloma is an incurable hematologic malignancy characterized by recurrent relapses and remissions. Immunotherapeutic agents such as immunomodulatory drugs and monoclonal antibodies have improved outcomes for relapsed refractory disease, however, the majority of patients still succumb to complications of relapsed disease. CAR T cells provide a mechanism of direct antigen specific myeloma cytotoxicity without graft versus host disease. Different complications such as cytokine release syndrome (CRS) or CAR T cell related encephalopathy syndrome (CRES) may occur which require prompt interventions. Early phase clinical trials with CAR T cell therapies have demonstrated very promising outcomes for relapsed refractory myeloma patients, especially when specific for the B cell maturation antigen (BCMA).