VIDEO: CAR-T therapies have 'taken over the world' in myeloma

I think that CAR-T’s treatment has just started. We have two CAR-Ts available. Both of them were approved based on a hundred patient, or thereabout, studies — small studies. It has taken over the world. Any patient who is eligible, the CAR-T is the first option we offer, and, unfortunately, it is approved right now as the fifth-line treatment. So, we have to give four lines before we do it, but whoever has four lines of treatment, we consider CAR-T. However, for future, there are a lot of new important areas of research in CAR-T, which is going to change it’s use. So, for example, current CAR-T requires production time of 4 to 6 weeks, sometimes 8 weeks. The new research, there is a study we presented recently where the CAR-T is made within 2 days’ time, so we can make it now in 2 days. That’s going to change the whole field on how it’ll be utilized and which patient it will be applicable to.  Number two, the type of cells we produce. In CAR-T, currently we produce what we produce; however, we need to develop a certain type of immune cell — whether they’re CD4, CD8 — but more importantly, we need immune cells which have memory phenotype, etc. And so the research is ongoing to have CAR T cells with a certain immunological phenotype. Number three, new targets. We are all working on developing a new target. Currently there are two CAR-T targets. One is, of course, BCMA, the other one is GPRC5D. But there are many more in pipeline and in lab research, which is going to be a very important component.  And the final two things is, one, beginning to use CAR-T at a different time point. We are now, we are comparing it with transplant, to replace transplant, and also in a newly diagnosed patient, so we are bringing it earlier on. So that’s a very important area. And finally, newer technology making dual CAR T-cells expressing two molecules at the same time, or target two molecules at the same time. We have this modular CAR where the CAR itself is not targeting the cancer cell or myeloma cell. However, it targets a molecule, and then we can inject an antibody bound to that molecule, which will then provide specificity to the tumor cell, specificity to the CAR. We can keep on changing the target with different antibodies, etc. So incredible advances are happening. And finally, maintenance treatment, CAR-T, some maintenance with bispecific, that might be the cure in myeloma. So, I think a lot of excitement, a lot of hope that all these treatments, especially driven by CAR-T, is going to cure myeloma in the very, very near future.