Introduction

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Imagine a single transfusion that uses your own cells to fight, or even cure, your cancer. That’s the goal of CAR-T therapy, an advanced treatment now being used for many blood cancers like multiple myeloma.

Multiple myeloma is a rare and aggressive blood cancer that affects plasma cells in the bone marrow. While standard treatments like chemotherapy and blood transplants exist, MM still frequently relapses and also refracts, or becomes harder to treat over time. That’s where CAR-T therapy comes in.

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​​​​​​​What is CAR-T Therapy?

 

To understand what CAR-T therapy is, first we have to be familiar with T cells. T cells are a type of immune cell naturally present in the body to find and kill invaders. However, cancer cells often evade detection by the T cells. 

So, CAR-T cell therapy involves taking the patient’s T cells and reprogramming them in the lab to have a CAR, or chimeric antigen receptor, attached. The CAR protein helps the T cells to recognize the cancer cells more effectively. It’s like giving your T cells a police sketch of the cancer cells so the T cells can find and destroy the cancer cells.

 

 

How the CAR-T Process Works

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1. T cell Collection: Patient's blood is drawn to collect T cells from their blood; this process is called apheresis

2. Engineering: In a lab, the CAR protein is attached to the T cells

3. Multiplication: The CAR-T cells are multiplied to a larger number

4. Infusion: Patient receive a single infusion of the CAR-T cells

5. Attack: These CAR-T cells now find and kill cancer cells

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Science Corner

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CAR-T cells work by using an antibody, a receptor which recognizes a specific protein on the surface of the cancer cell. 

When this receptor binds to the cancer cell, it triggers a chain reaction inside the T cell that causes the T cell to release toxins, like cytokines, to destroy the cancer cell. 

This is why its important that the CAR-T cell antibody targets a protein that is only on the cancer cell, or else it could mistakenly attack healthy cells.

Both of the approved CAR-T therapies for Multiple Myeloma, listed below, use an antibody targeting the protein BCMA, which is found exclusively on the multiple myeloma cells. 

 

 

Approved CAR-T Therapies for Multiple Myeloma

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As of July 2025, there are two FDA-approved CAR-T therapies for Multiple Myeloma:

• Abecma (idecabtagene vicleucel)

• Carvykti (ciltacabtagene autoleucel)

These CAR-T therapies are used after four or more lines, or different types, of treatments have been used, including:

• an immunomodulating agent

• a proteasome inhibitor

• an anti-CD38 monoclonal antibody

 

How Does CAR-T Compare to Standard Therapies?

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Benefits:

• Largely successful results: in an FDA clinical trial for Carvykti 98% of patients saw reduced cancer, and 76% saw complete removal of cancer for an average of 22 months 

• Once time infusion: Unlike rounds of chemotherapy and blood transplants, CAR-T therapy only requires a single transfusion

Challenges:

• Side effects

  • Cytokine Release Syndrome (CRS): a common side effect where the CAR-T cells release an excess of the cancer-killing toxins, called cytokines, into the bloodstream. This can cause issues such as high fever, nausea, increased heartbeat, and muscle pain. 

  • Neurological issues: also known as immune effector cell-associated neurotoxicity syndrome (ICANS); side effects range from headaches and mild confusion to seizures and difficulty speaking (aphasia)  

• Very high cost: the treatment can cost around $465K+

 

Patient Resources

Find a CAR-T Center

• Abecma Center Finder

• Carvykti Treatment Locator​

Explore Clinical Trials

• CAR-T Trials for MM on ClinicalTrials.gov