The first clinical trial in Ireland using groundbreaking cell therapy to treat multiple myeloma has opened, with researchers hoping patients will benefit from “sustained remission” from the blood cancer.
A small number of multiple myeloma patients will be enrolled in the trial at St James’s Hospital in Dublin to evaluate the use of Car-T as a frontline therapy in patients newly diagnosed with the cancer, and for whom stem cell therapy is not planned initially.
Multiple myeloma is the second most common blood cancer, with about 2,200 people living with it and 350 people newly diagnosed annually. It starts in the bone marrow, most commonly affects people aged over 65 and is more common in men than women. Aslan singer Christy Dignam has been living with the condition for a decade.
Despite significant advances in treatment for it in recent years, high unmet need remains. Multiple myeloma is incurable, with an average survival time of eight to 10 years.
Car-T (Chimeric Antigen Receptor – T cell) is a “living drug” that modifies the body’s T cells so they can better recognise and attack cancer. It involves collecting a patient’s T cells, part of the immune system, which are re-engineered to target cancer cells. The modified T cells are then reinfused in patients.
Consultant haematologist Dr Larry Bacon said Car-T used in this trial had proven its worth in relapsed patients who had tried up to eight lines of other therapy. Its two-year survival rate is 70 per cent. Car-T was first licensed in the US against leukaemia in 2017. Since then, researchers have been seeking to extend its repertoire against other forms of cancer.
“Our sense is, the earlier you get this, the better,” Dr Bacon said of the treatment.
His unit began using Car-T to treat patients in December 2021, and has since infused 25 patients with two conditions, diffuse large B-cell lymphoma and B-cell acute lymphoblastic leukaemia, with the immunotherapy.
Initial indications pointed to a 40-50 per cent survival rate for these patients, he said. While not a cure for multiple myeloma, researchers would be looking for “sustained remission” in patients, he added.
Patients participating in the trial will be administered six cycles of chemotherapy, each one lasting three weeks, on an outpatient basis before starting Car-T treatment. The trial, which is sponsored by the pharma company Janssen, is the result of a collaboration between multiple departments in St James’s, the Department of Health, the Health Products Regulatory Authority and the National Cancer Control Programme.