A treatment for multiple myeloma that harnesses the body’s cancer-fighting T cells was safe in humans and showed preliminary signs of effectiveness, according to a clinical trial involving 23 patients with relapsed or treatment-resistant disease. Although more research is needed to determine how well the treatment works, the trial results indicate that the regimen may be safer than other cell therapies and may improve outcomes in people with advanced multiple myeloma. Patients with this cancer often stop responding to standard treatments after some initial success, leaving them with no curative options. Cell therapies such as CAR T cells — immune cells genetically modified to better hunt cancer cells — have shown promising response rates of more than 80%, but patients still frequently relapse after the first year of treatment and can suffer from severe side effects. There is therefore a substantial need for new treatments that are both safer and more durable over the long term. Premal Lulla and colleagues tackled both of these issues with their autologous multitumor-associated antigen-specific T cells, which they developed using cells from 23 patients. Instead of genetically modifying the cells, the authors isolated and enriched T cells bearing receptors that showed the strongest responses to 5 multiple myeloma-linked proteins. The team infused the cells into 21 patients and observed that the treatment was generally well-tolerated, as only one patient showed strong side effects. Three patients showed objective clinical responses, and the team noted that patients with active disease survived for an average of 22 months after treatment. Lulla et al. caution that phase 2 or 3 trials involving larger samples of patients will be needed to better establish their treatment’s efficacy.
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