I. Introduction. Multiple myeloma (MM) is a malignant clonal disease originating from the bone marrow, which is characterized by abnormal proliferation of monoclonal plasma cells, resulting in symptoms such as hypercalcemia, renal impairment, and anemia. The incidence of multiple myeloma is relatively high, and its incidence is increasing with the aging of the population. Although there are a variety of methods, such as chemotherapy, radiotherapy, stem cell transplantation, etc., the rate and drug resistance of multiple myeloma are still high. In recent years, chimeric antigen receptor T cells (CAR-T)** have made significant progress in multiple myeloma**. This article will introduce the principle, application status and future development trend of CAR-T** multiple myeloma.
2. Chimeric antigen receptor T cell (CAR-T)** principle.
CAR-T is an adoptive cell immunity** method that enhances the killing effect of T cells on tumor cells by modifying a patient's own T cells to express chimeric antigen receptors that recognize tumor antigens. CAR-T** is first extracted from the patient's body, genetically engineered to express a chimeric antigen receptor, and then amplified in vitro and then infused back to the patient. The engineered T cells can specifically recognize and attack tumor cells expressing corresponding antigens, exerting powerful anti-tumor effects.
3. Application of CAR-T in multiple myeloma**.
At present, there are several CAR-T products used in multiple myeloma, such as Idecabtagene Vicleucel and CiltaCabtagene Autoleucel. These products work primarily by recognizing and attacking tumor cells that express BCMA (B cell maturation antigen). In clinical trials, these CAR-T products have shown better efficacy and lower efficacy
Fourth, clinical trial data display.
Results from multiple clinical trials have shown significant clinical remission in patients with multiple myeloma treated with CAR-T**. At long-term follow-up, some patients even achieved durable remission. These results suggest that CAR-T** is expected to be an effective means of multiple myeloma.
5. Problems and coping strategies.
Although CAR-T** has achieved remarkable efficacy in multiple myeloma, some patients still develop **. This may be related to factors such as the heterogeneity of tumor cells, immune escape mechanisms, etc. In order to address the problem, researchers are exploring ways to combine other methods (such as chemotherapy, radiotherapy, etc.) as well as to develop novel targets. In addition, monitoring the persistence and function of CAR-T cells in patients can help with timely detection** and interventions.
6. Novel targets and next-generation CAR-T**.
Currently, CAR-T** for multiple myeloma mainly targets BCMA antigens. However, BCMA-negative or low-BCMA expression tumor cells may escape the killing effect of CAR-T**. Therefore, the development of CAR-T products against other antigens is one of the future research directions. In addition, researchers are also exploring CAR-T** methods based on novel targets such as G protein-coupled receptor class C and signaling lymphocyte activating molecule family 7 (SLAMF7). These new targets may provide more options and broader application prospects for multiple myeloma.
7. Summary and prospects.
CAR-T** has made significant progress in multiple myeloma, providing patients with a new ** option. However, the issue still needs to be further addressed. Future research directions include the development of CAR-T products for other antigens and the exploration of novel target-based methods. With the continuous advancement and innovation of technology, we believe that CAR-T** will play a greater role in the development of multiple myeloma, bringing better quality of life and prognosis to patients.