How CAR T-Cell Therapy Treats RRMM

CAR T-cell therapy is a type of immunotherapy that uses genetically engineered T cells to target and destroy cancer cells. In the case of relapsed or refractory multiple myeloma (RRMM), CAR T-cell therapy works by targeting the B cell maturation antigen (BCMA), which is a protein expressed on the surface of myeloma cells.

Here's an overview of how CAR T-cell therapy treats RRMM:

1. Collection of T cells: T cells are collected from the patient's blood through a process called apheresis.

2. Genetic engineering: The collected T cells are genetically modified in the laboratory to express a chimeric antigen receptor (CAR) that specifically recognizes BCMA. CARs are artificial receptors that consist of an extracellular antigen-binding domain, a transmembrane domain, and an intracellular signaling domain.

3. Expansion and activation: The genetically engineered T cells, now known as CAR T cells, are expanded and activated in the laboratory. This involves stimulating the T cells with cytokines and growth factors to multiply and become more potent.

4. Infusion: The expanded and activated CAR T cells are infused back into the patient's bloodstream through an intravenous (IV) line.

5. Target recognition: Once inside the patient's body, the CAR T cells circulate through the bloodstream and search for cancer cells expressing BCMA. When a CAR T cell binds to BCMA on a myeloma cell, it becomes activated.

6. Cell killing: Upon activation, the CAR T cell releases cytotoxic molecules such as perforin and granzymes, which create pores in the myeloma cell membrane, leading to cell death. Additionally, CAR T cells can induce apoptosis (programmed cell death) in myeloma cells.

7. Expansion and persistence: The activated CAR T cells divide and proliferate, creating a large population of BCMA-specific T cells. These CAR T cells can persist in the patient's body for months or even years, providing long-term protection against myeloma.

8. Immune memory: CAR T cells have the ability to develop immunological memory, which means they can recognize and destroy myeloma cells if the disease relapses in the future.

CAR T-cell therapy for RRMM has shown promising results in clinical trials and is now an approved treatment option for patients who have failed multiple lines of therapy. However, further research is ongoing to improve CAR T-cell efficacy, reduce side effects, and expand its use to a broader range of patients.