Oncology Pulse Masthead

November 2023

Challengers to Auto CAR-T in Liquid Tumors

  • The approval of autologous chimeric antigen receptor (CAR)-T cell therapy dramatically improved outcomes for patients with multiple myeloma and aggressive lymphoma; however, the treatment comes with major logistical challenges, safety concerns and high cost
  • More recently, bispecific T-cell engagers have emerged, offering an off-the-shelf alternative with potentially better safety but lower efficacy
  • For now, autologous CAR-T is prioritized for those who are candidates for both, due to longer term data, especially as it relates to durability of response
  • But, both approaches are seeking to push into earlier lines as part of combination regimens, and allogeneic CAR-Ts are aiming to provide the efficacy of CAR-T with an off-the-shelf product

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There are two distinct T-cell therapy based approaches available to treat multiple myeloma (MM) and aggressive lymphomas 

Approved T-Cell Therapies in Multiple Myeloma and Non Hodgkins Lymphoma

In MM, bispecifics may lag in ORR compared to auto CAR-T

but offer significantly better safety

Auto CAR-T vs. Bispecific (Multiple Myeloma)

Similar observations for auto-CART vs. bispecifics

hold true for LBCL/DLBCL 

Auto CAR-T vs. Bispecific (LBCL/DLBCL)

Long-term follow up and one time treatment favor auto CAR-T over bispecifics; allogeneic CAR-T is aiming to offer the best of both

Comparison of T-cell Based Therapies

2024 could see the first allo CAR-T pivotal read out; other trials could move auto CAR-T and bispecifics into earlier lines, raising questions about optimal candidates for each and sequencing

Pivotal Trials to Watch in Multiple Myeloma and LBCL/DLBCL

We are looking forward to new data at ASH 2023 exploring use in earlier lines of therapy and in novel combinations

We'll be at ASH 2023!

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