What factors contribute to resistance to BCMA-targeted CAR T-cell therapies in multiple myeloma?

During the 6th European CAR T-cell Meeting of the European Hematology Association and European Society for Blood and Marrow Transplantation, the Multiple Myeloma Hub spoke to Paola Neri, University of Calgary, Calgary, CA. We asked, What factors contribute to resistance to B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T-cell therapies in multiple myeloma?

In this interview, Paola Neri discusses the factors associated with either a lack of response to BCMA-targeted CAR T-cell therapies or loss of response over time, going on to offer insight into the management strategies for these patients. Neri highlights key issues of antigen escape, mutation of BCMA, as well as T-cell exhaustion; she closes with the additional considerations required for difficult-to-treat forms of multiple myeloma, such as extramedullary disease.^1,2,3