Cilta-cel salvages ide-cel failure in relapsed multiple myeloma by driving distinct immune responses.

ABSTRACT: Ide-cel and cilta-cel are the two FDA-approved anti-BCMA CAR T cell therapies for the treatment of relapsed/refractory multiple myeloma. Here, we studied a patient who was initially treated with ide-cel with progressive disease and subsequently treated with cilta-cel with a complete response. To elucidate the underlying mechanisms underpinning the distinct clinical outcomes, we conducted multimodal, cross-tissue, and longitudinal single-cell analyses. This enabled us to directly compare the specific cellular and molecular factors distinguishing these two CAR therapies including their cell phenotypes, post-infusion kinetics, and endogenous immune landscapes. We found that the ide-cel infusion product was dominated by CD4⁺ CAR T cells, upregulated a terminal effector phenotype, an

SUBMITTER: Pan T 

PROVIDER: S-EPMC12265789 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature