VIDEO: CAR-T for multiple myeloma ‘is here to stay’

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In the immediate sense, I think it means that we are gaining a very promising and unquestionably effective therapeutic modality for patients who, just a couple years ago, really had very little, perhaps, if any, good options once the point of, you know, triple class refractory disease was reached. And again, you know, I'm not just speaking in superlatives here. Just literally two years ago, you know, we were left with kind of old school, multi-agent cytotoxic chemotherapy to try to buy time for patients with unfortunately median survival times in terms of months. And since then, we've had essentially four new FDA approvals, each of which is an entirely new class of drugs an entirely new mechanism of action in the myeloma space. And so the past two years, I think have been really productive. In terms of CAR-T specifically, it's the only one of these new modalities that really, you know, not only approaches a 50% response rate, but significantly exceeds that, which is very exciting. When you're talking about ide-cel or ABECMA, you know, you're looking at, you know, around a three out of four response rate based on the KarMMa data. And then when you're looking at newer CAR-T cell constructs, and I guess just to mention the one that is appropriately getting the most buzz, when you look at Cilta-cel, based on the recent CAR-T2 data with almost a 100% response rate and the CAR-T1 dataset. I think that means that number one, CAR-T is here to stay. Number two, it is going to be a therapy of choice. I don't want to say the therapy of choice, because again, I don't necessarily think it's for absolutely everyone, but definitely a therapy of choice for patients who reach the point of triple class refractoriness. And three, again, I can't predict the future and I have no insider information, but I personally, based on the CAR-T2 data, I don't see why Cilta-cell would not be approved and not be an option hopefully in the near future. And that means that hopefully, we may have more than one CAR-T cell option. Which just in terms of access and in terms of kind of the current supply and demand difficulties that, you know, it's public information, that right now the Beckman rollout is, you know, understandably going through some hiccups. But as we have more options, especially for a kind of therapy like CAR-T cell that not only requires, you know, it's not just a drug on the shelf, you know, but there's a lot of things that have to fall in place and a lot of important steps along the assembly line, so to speak, that have to occur for a successful therapy to happen. But as we have more options, I think, kind of the current bottleneck or lack of immediate access to CAR-T, so it'll hopefully be a thing of the past in the very near future. So I could go on and on, but I think those are the ways in which I see CAR-T cell as being immediately impactful and then, not to speculate too much into the future, but CAR-T cell is being evaluated earlier and earlier lines of therapy to include, even now in the first line in a consolidated setting. So I think sky's the limit and I don't know how things are gonna play out over the next few years. I'd be lying if I said that I did, but I would be surprised if CAR-T cell does not make its way into significantly earlier lines of therapy. Perhaps not for everyone, but perhaps for at least some patients with either high-risk disease or other disease characteristics that we'll eventually figure out. You know, portend a especially good outcome from this type of immunotherapy. So it's arrived officially. It's not going anywhere, and I think it's going to become an increasingly more important and more beneficial modality of therapy for our patients.