Review of CAR T-Cell Therapy in Multiple Myeloma:
A Canadian Perspective
Steven Chun-Min Shih and Sita Bhella
Abstract
Multiple myeloma (MM) is an incurable plasma cell malignancy. In the context of the
current standard of care therapies in Canada, outcomes among patients with relapsed/refractory
multiple myeloma (RRMM), particularly those with triple-class (or more) refractory disease remain
poor. Immunotherapies have significantly changed the treatment landscape of MM. Since 2021, two
BCMA-targeting CAR T-cell therapy products have been approved for RRMM—namely Idecabtagene
vicleucel (Ide-cel) (ABECMA®) and Ciltacabtagene autoleucel (Cilta-cel) (CARVYKTI®), both of
which are available in the US and Europe. Although they have shown unprecedented efficacy in
RRMM, their clinical and logistical limitations must be acknowledged. MM CAR T-cell therapy is
likely to be approved in Canada soon. Therefore, it is timely that we review the latest evidence
for commercially available CAR T-cell therapy in multiple myeloma, with a focus on its relevance
and impact in the Canadian setting. There will be challenges to access and strategies must be in
place to ensure equitable care for all Canadians with MM. Alongside haematologists working in
the immune effector cell therapy programs, providers in the community will also play a role in the
ongoing monitoring and management of long-term side effects including opportunistic infections
and late neurotoxicity.
Keywords: myeloma; immunotherapy; CAR T
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