Smoldering CAR-T trial in multiple myeloma raises long-term hopes

Angus Cheng covers all issues broadly related to cancer, including medicines, policy, science and stocks. She joined STAT in 2021 after covering health and science at NPR and NPR affiliate stations. His work has been recognized with the national Edward R. Murrow Award and the June L. Biedler Award for Cancer Journalism, among others. You can access Angus.08 on Signal.

SAN DIEGO — Allison Cameron fought to keep her myeloma under control for nearly a decade. She was diagnosed with smoldering multiple myeloma, a precursor to cancer, and had been on IV fluids for years to prevent it from progressing to active multiple myeloma. The 54-year-old anesthesiologist, who is currently undergoing clinical trials with CAR-T therapy, an aggressive form of immunotherapy, hopes his cancer risk will be completely eliminated.

That’s a reasonable expectation given the results of that trial, which researchers presented Monday at the American Association for Cancer Research meeting here. All 20 patients who received the study treatment no longer had detectable myeloma cells in their bodies. This is a much deeper and more complete response than scientists typically expect for multiple myeloma, leading some experts to consider the possibility that these patients may have truly avoided aggressive cancer forever.

Currently, there is only one treatment approved for high-risk smoldering myeloma: an antibody therapy called Darzalex. Patients can continue to receive treatment for years, but such deep molecular responses are not achieved, and many patients still progress within five years, said Ekaterina Dumbrava, a cancer researcher at MD Anderson Cancer Center who was not involved in the study. “These results raise a very important question: whether early immune blockade can not only slow progression but also redefine treatment goals. Can we talk about the word we always avoid: cure?” she said.