CAR-T cell therapy is providing a different approach to treating multiple myeloma by using genetically modified immune cells to recognise and attack cancer cells.
The treatment takes T cells from a patient’s own immune system and modifies them so they can identify a specific target on cancer cells. The cells are then multiplied and returned to the patient, where they can seek out and attack the targeted cells.
Multiple myeloma is a cancer of plasma cells and can become difficult to treat after several previous therapies. CAR-T therapy has therefore emerged as an additional treatment option for some patients whose disease has returned or stopped responding to previous treatments.
The approach differs from conventional drug treatment because the therapeutic agent is made from the patient’s own immune cells. Rather than introducing a medicine designed to attack cancer cells directly, CAR-T modifies T cells to recognise a specific target associated with the cancer.
Clinical studies have reported responses among patients with relapsed or refractory multiple myeloma who have received multiple previous treatments. Two BCMA-directed CAR-T therapies, idecabtagene vicleucel and ciltacabtagene autoleucel, have demonstrated significant activity in this setting. Further studies have also examined their use at earlier stages of treatment.
Research is now moving beyond the use of CAR-T therapy in heavily pre-treated patients. Clinical trials have investigated whether the treatment can be used earlier in the course of multiple myeloma, when patients may have healthier T cells and lower levels of disease.
Randomised trials have reported improved progression-free survival for CAR-T therapies compared with standard treatment in certain second- and third-line multiple myeloma populations. This has increased research interest in moving CAR-T treatment further towards earlier lines of therapy.
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