Anti-BCMA CAR-T cells therapy for a patient with extremely high membrane BCMA expression: a case report. Issue 9 (22nd September 2022)

• Record Type: Journal Article
• Authors: Li, Dan; Que, Yimei; Ding, Shengnan; Hu, Guang; Wang, Wen; Mao, Xia; Wang, Ying; Li, Chunrui; Huang, Liang; Zhou, Jianfeng; Zhang, Wei; Xiao, Min
• Is Part Of: Journal for immunotherapy of cancer. Volume 10:Issue 9(2022)
• Publication Date: 2022-09-22
• Subjects: Immunotherapy -- Cytotoxicity, Immunologic; Cancer -- Immunotherapy -- Periodicals; Cancer -- Immunological aspects -- Periodicals; Tumors -- Immunological aspects -- Periodicals; Immunotherapy -- Periodicals; 616.99406105
• DOI: 10.1136/jitc-2022-005403
• Languages: English
• ISSNs: 2051-1426

Abstract

Abstract : B cell maturation antigen (BCMA)-directed CAR-T cell therapy is a disruptive approach for treating relapsed/refractory multiple myeloma (R/R MM); however, optimization is necessary to maximize patient benefit. We report the case of a 61-year-old woman with primary refractory MM who presented with high expression of membrane BCMA and low expression of soluble BCMA (sBCMA), experienced grade 4 cytokine release syndrome, and died fromsevere pneumonia after receiving anti-BCMA CAR-T (CT103A) therapy. This case highlights the importance of assessing the expression range of BCMA for its efficacy and safety in patients receiving BCMA CAR-T therapy. For patients who present with extremely high membrane BCMA expression and extremely low sBCMA expression, the presence of γ-secretase-related gene mutations should be considered. Special attention should also be paid to the prevention and treatment of cytokine release syndrome in such patients.