CAR-T Versus Salvage Autologous or Allogeneic Stem Cell Transplantation for Relapsed Multiple Myeloma

Nico Gagelmann, MD, of the University Medical Center Hamburg-Eppendorf in Germany, discussed his abstract on the role of chimeric antigen receptor (CAR) T-cell therapy versus salvage autologous or allogeneic stem cell transplantation for relapsed multiple myeloma (MM) at the 65th American Society of Hematology Annual Meeting & Exposition.

According to Dr. Gagelmann, salvage treatment has been the standard of care for relapsed myeloma for the last 10 to 15 years if there is no other treatment option. “But now, since we have CAR T-cell therapy, it’s really, really important to understand whether CAR T-cell therapy can actually be better for these patients than quite intensive treatment with autologous or allogeneic stem cell transplantation,” he said.

In this propensity score matched analysis, Dr. Gagelmann and colleagues determined that CAR-T, while complex and expensive, has better progression-free survival and a better response rate than autologous or allogeneic stem cell transplantation.

“If we can expand the access to CAR T-cell therapy for salvage treatments for relapsed myeloma, we should first go for CAR T-cell therapy and then for allogeneic or autologous stem cell transplantation as salvage, because it has a much better safety profile and much better responses,” Dr. Gagelmann concluded.