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Archive > Volume 29 Issue 9 > 2022,29(9):791-796. DOI:10.3872/j.issn.1007-385X.2022.09.002 Prev Next
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The treatment of multiple myeloma by CAR-T cells：the problems and countermeasures
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Abstract:
Multiple myeloma，the second most common hematologic malignancy, is caused by the abnormal growth of plasma cells in bone marrow. The increasing number of biological treatment methods provides new ideas for the treatment of multiple myeloma, and CAR-T cell therapy brings the possibility of a cure for relapse/refractory multiple myeloma patients. CAR-T cells targeting different multipke myeloma specific molecules have shown good results in clinical trials. However, insufficient efficacy duration and disease recurrence are still associated with CAR-T cell therapy, which may be associated with persistent CAR-T cells deficiency, loss of tumor cell surface antigen expression, antigen escape and impaired T cell activity in the immunosuppressive microenvironment. Clinical studies have been conducted to improve the effector function and duration of CAR-T cells by optimizing CAR design, adjusting the preparation process to generate CAR-T cells rich in specific T cell subsets, constructing universal CAR-T cells derived from healthy volunteers and introducing modification genes to regulate the immunosuppressive microenvironment or improve the proliferation capacity of CAR-T cells. And clinical studies have been conducted to improve the safety of CAR-T cell therapy by reducing the immunogenicity of antibodies in CAR structures and introducing switching mechanisms. These studies have injected new vigor into the treatment of multiple myeloma and will provide new methods and options for anti-tumor immunotherapy.
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