EN
1. What is multiple myeloma? |
2. What is CAR-T therapy? |
3. The treatment process |
4. Effectiveness of CAR-T therapy |
5. Side effects of CAR-T therapy |
6. Clinic recommendations |
7. Cost of treatment |
According to the latest data from the American Society of Clinical Oncology, more than 176,000 new cases of multiple myeloma have been identified in 2020. It is an oncological disease that affects the plasma cells in the bone marrow, which are responsible for producing antibodies and fighting infections. The disease is accompanied by weakened immunity, dangerous complications and frequent relapses. However, thanks to the united work of scientists, it was possible to create a drug that shows excellent results in patients with myeloma – it increases immunity, reduces the number of cancer cells and, most importantly, prolongs the life of patients. We are talking about CAR-T therapy. What this drug is, how it helps to resist cancer, where to undergo treatment and how much it costs – MediGlobus has prepared answers to all these questions.
What is multiple myeloma?
Multiple myeloma (plasmacytoma) is a type of blood cancer. This disease affects plasma cells in the bone marrow, which are responsible for immunity.
Plasma cells degenerate into cancer cells and begin to divide uncontrollably, gradually displacing normal cells. This reduces the number of platelets, and red and white blood cells, leading to severe anaemia, bleeding, and a decrease in the resistance to infections. In addition, myeloma cells produce an abnormal body – M-protein. Its accumulation damages kidneys and other organs. Also, myeloma damages bones, which increases the risk of fractures.
The disease develops mainly in adults (typically those older than 60), with a predominance of men. Multiple myeloma in children is extremely rare.
Doctors cannot predict with 100% accuracy how myeloma will progress or how long people will live with it. The prognosis depends on many factors. Survival rates range from 1 year to more than 10 years. According to the Multiple Myeloma Research Foundation, the relative 5-year survival rate is 59,8%.
The disease requires a comprehensive approach. Treatment regimens for myeloma include induction chemotherapy to kill cancer cells, stem cell transplantation to rebuild bone marrow, and maintenance therapy to manage symptoms and complications. These are the main treatments. However, it is not always possible to achieve a positive result with their help. Many patients develop resistance to drugs and the disease relapses anew. In such cases, doctors turn to alternative methods, like CAR-T therapy.
Contact the medical experts at MediGlobus to learn more about multiple myeloma, including diagnostics and treatment. Leave your phone number using the button below and wait for a coordinator to call you.
Read: How is CAR-T cell therapy used in oncology?
CAR T-cell therapy is a new method of cancer treatment, which as of 2021 began to be used for myeloma disease as well. It is recommended for patients who have not responded to standard methods (usually at least 4 treatments) or have a relapse of the disease. This approach is based on genetically modifying the patient’s T-lymphocytes (immune cells) to increase their ability to fight cancer cells.
The process begins with leukapheresis – the extraction of T-lymphocytes from the patient’s blood. These cells are then frozen and sent to a laboratory where they undergo reprogramming. A special gene encoding a chimeric antigen receptor CAR is inserted into them. This receptor gives T-lymphocytes the ability to accurately recognise and attack cancer cells. The modified cells are then multiplied in the laboratory and returned to the patient’s body as an injection. The renewed immune cells detect the cancer cells, attach to them and destroy them.
What is the treatment process like?
Leukapheresis (a procedure to collect T lymphocytes) can take several hours. During it, the patient’s blood is fed through a system into a machine that extracts lymphocytes from it. The blood is then returned to the patient.
It takes about a month for the T-lymphocytes to be processed in the lab and the preparation to be made.
Before the drug administration procedure, the patient undergoes chemotherapy to prepare the body for the treatment. This may take several days to complete.
The drug with CAR-T cells is administered intravenously through an IV drip. The procedure is administered to patients 2-4 days after chemotherapy.
20-30 minutes before the IV, the patient takes acetaminophen and antihistamines to prevent complications. After the procedure, you need to be under medical supervision for 7-10 days to control possible side effects.
CAR-T therapy is carried out exclusively in medical centres that have the appropriate authorisation and certificate.
Ask our coordinator about the possibility of treating myeloma disease abroad. We will answer all your questions and help you organise your trip.
How effective is CAR-T cell therapy for multiple myeloma?
Currently, the FDA has approved 2 CAR-T therapy drugs for the treatment of recurrent myeloma – Abecma (idecabtagene vicleucel) and Carvykti (ciltacabtagene autoleucel). The drugs have undergone a series of trials and were proven to be highly effective treatments.
Blood and Lymphatic Cancer: Targets and Therapy journal describes the results of studies on Idecaptagene Vicleucel and Ciltacabtagene Autoleucel. The therapy promotes a significant reduction or complete disappearance of tumours over a long period.
“Results from previous trials conducted by my group at NCI have shown that CAR-T cells can be an effective treatment for multiple myeloma,” says Dr James Kohenderfer of the NCI Cancer Research Centre. – “We need to keep working to improve treatments and try to permanently cure patients of multiple myeloma.”
The results of Idecaptagene Vicleucel therapy showed that 73% of patients responded to treatment and the disease did not progress at 8,8 months. Furthermore, at higher doses, 100% of patients achieved a complete response and the effect persisted for up to 11,8 months.
Ciltacabtagene Autoleucel also demonstrated a high overall response with 98% of patients in remission at 8,8 months. After 27 months, survival rates were 55%, which is an excellent result.
According to Dr Kohenderfer, patients do not need to take any additional medication after CAR-T therapy, which significantly improves their well-being and quality of life: “This is a significant difference from standard treatments for myeloma disease, where patients need to take medication even when in remission.”
Dr James Kohenderfer and his team have been researching and developing CAR-T cell therapy drugs since 2013. In that time, they have seen some amazing cases. One of them was particularly memorable for the doctor. The study involved a patient with a very complex form of the disease. None of the standard therapies worked for him. After CAR-T cell therapy, he went into complete remission, which lasted for more than 3 years.
Side effects of CAR-T therapy
Despite the high effectiveness of the treatment, CAR-T cell therapy can cause side effects. Therefore, this procedure is performed only in certified clinics by specially trained specialists who know how to prevent and what to do in case of complications.
One of the most dangerous complications is cytokine release syndrome (CRS). This is the body’s acute reaction to treatment that develops due to the intense release of cytokines. Symptoms include fever, difficulty breathing, nausea, dizziness, fatigue, etc. In most cases, this condition is mild and can be easily managed with medication. However, in rare cases, it can be life-threatening.
The journal Blood and Lymphatic Cancer: Targets and Therapy states that 84% to 95% of patients have experienced this complication. However, only 4% to 5% had severe complications.
Neurological symptoms are also possible after CAR-T therapy, which are manifested by headaches, seizures, tremors, problems with speech, balance, and confusion. According to research data, such complications occurred in 18%-21% of patients, and in severe form, they occurred in 3%-9% of patients.
Other side effects include allergic reactions, increased risk of infections, and bleeding.
Due to the risk of the above side effects, patients are advised to refrain from driving, working with heavy machinery and other activities requiring attention and physical exertion for the first 8 weeks after therapy.
Where is CAR-T cell therapy for myeloma disease available?
CAR-T therapy is performed in medical centres approved to use this method. Such clinics are located in Israel, China, Spain and Germany:
Cost of treating multiple myeloma with CAR-T therapy in 2024
| Country | Cost |
|---|---|
| Israel | from $80,000 |
| China | from $65,000 |
| Country | Cost |
|---|---|
| Spain | from €400,000 |
| Germany | from €450,000 |
Summary
Multiple myeloma is a type of blood cancer which affects plasma cells in the bone marrow. The disease leads to severe anaemia, bleeding, reduced ability of the body to fight infections, internal organ dysfunction, and bone destruction.
In myeloma disease, treatment is complex. However, standard therapy is not always effective. Many patients develop resistance to drugs and the disease relapses. In such cases, doctors turn to alternative methods, among which is CAR-T therapy.
CAR-T therapy is a new method of treatment for multiple myeloma based on genetic modification of a patient’s T-lymphocytes to increase their ability to fight cancer cells.
T-lymphocytes are extracted from the patient’s blood and processed in a laboratory to improve their ability to recognise and destroy cancer cells. The modified cells are then returned to the patient’s body as an injection.
CAR-T therapy is recommended for patients with multiple myeloma who have not responded to standard treatments (usually at least 4 treatments) or have a relapse of the disease.
The FDA approved 2 CAR-T therapy drugs for the treatment of multiple myeloma – Abecma (idecabtagene vicleucel) and Carvykti (ciltacabtagene autoleucel). The drugs have undergone a series of trials and have proven to be highly effective.
According to studies, between 73% and 98% of patients respond to treatment. And remission lasts from 8 to 11 months. The survival rate after 27 months is 55%.
CAR-T therapy has side effects – cytokine release syndrome, neurological disorders, allergic reactions, increased risk of infections and others.
CAR-T therapy is performed in medical centres that have permission to use this method. Such clinics are located in Israel, China, Spain and Germany.
The cost of treatment of myeloma with CAR-T therapy differs depending on the country. In Israel, the therapy costs $80,000, in China from $65,000, in Spain from €400,000, and in Germany from €450,000.
If you have been diagnosed with the blood disorder myeloma and are interested in CAR-T therapy, contact the experts at MediGlobus. We will provide you with a free consultation and share all the information you need about treatment. We can also help you choose a clinic, book an appointment and go for treatment as soon as possible.
Sources:
- 1. American Society of Clinical Oncology (ASCO)
- 2. Multiple Myeloma Research Foundation
- 3. American Cancer Society
- 4. Blood and Lymphatic Cancer: Targets and Therapy
- 5. National Cancer Institute
