Yan Leyfman, Medical Oncologist, Co-Founder and Executive Director of MedNews Week, shared a post on X about a recent article by Junia Vieira dos Santos et al, published in Blood Advances:
“Long-Term CAR-T Insights: Lessons from Cilta-cel in Myeloma
In-depth multi-omic profiling from Mount Sinai’s CARVYKTI (cilta-cel) experience sheds light on why some patients sustain >5-year remissions post–CAR-T.
Key takeaways:
- Durable responders show higher endogenous T-cell diversity, especially within CD4⁺ memory pools, and lower baseline plasma cell burden.
- Early expansion of CAR-Ts and NK/T cells peaks ~week 2, marking a potent immune “primer” phase.
- Long-term remission depends less on CAR-T persistence and more on the breadth of endogenous T-cell recovery and immune homeostasis.
- Poor responders exhibit MDSC expansion and terminally differentiated T-cell phenotypes, signaling immune exhaustion.
- Proteomic data highlight sCD70/sCD28 and TWEAK (TNFRSF12A) as potential biomarkers of sustained response.
Bottom line: Durable tumor control after BCMA CAR-T may rely on a balanced immune reconstitution—not just CAR-T persistence.
This supports strategies that enhance endogenous T-cell rejuvenation or checkpoint synergy post-infusion.”
Title: Long-term Remission After Cilta-Cel in Multiple Myeloma Is Linked to Diverse T Cells and Low Myeloid Suppression
Authors: Junia Vieira dos Santos, David T Melnekoff, Adolfo Aleman, Tarek H Mouhieddine, Rocio Montes de Oca, Feng Wang, Sridevi Rajeeve, Sherry Bhalla, Oliver Van Oekelen, Bhaskar Upadhyaya, Yogita Ghodke-Puranik, Violetta V Leshchenko, Seunghee Kim-Schulze, Adeeb Habibur Rahman, Shaked Afik, Hadas Lewinsky, Vicki Plaks, Santiago Thibaud, Hearn Jay Cho, Joshua Richter, Cesar Rodriguez, Larysa J Sanchez, Adriana C Rossi, Shambavi Richard, Ajai Chari, Deepu Madduri, Sundar Jagannath, Samir Parekh, Alessandro Lagana
Read the Full Article on Blood Advances
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