In a conversation dedicated to the current state of CAR T-cell therapy and other cellular treatments in multiple myeloma, Joshua Richter, MD, and Marco Davila, MD, PhD, offered their biggest takeaways that community oncologists should keep in mind about the field. Davila emphasized that cellular therapy is “one of the biggest opportunities” for patients to achieve long-term remissions, which necessitates working closely with referrers to optimize bridging therapy, post-infusion care, and other aspects of treatment. Based on the current trajectory of the field, Richter anticipated that cell therapy will eventually become a part of the therapeutic strategy for patients with newly diagnosed multiple myeloma.
Davila is physician–scientist and service chief of the Lymphoma–Myeloma Adoptive Cell Therapy Service at Roswell Park Comprehensive Cancer Center. Richter is associate professor of medicine at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and director of Myeloma at the Blavatnik Family Chelsea Medical Center at Mount Sinai.
Transcript:
Richter: As a final thing, you have 2 minutes in front of a community oncologist who doesn’t have your knowledge and understanding of CAR T-cell therapy in [multiple] myeloma. What would be your biggest pearls that you’d want to pass on from what we’ve talked about today?
Davila: With referrers and even with patients, it’s just highlighting: why am I so pro-cell therapy? It’s the outcomes. The entire goal of myeloma—before the “C” word, maybe, let’s not go into that—is to put the patient in remission as long as possible. For me, cell therapy is one of the best opportunities available for patients to put them into remission for years. That’s the goal. Starting those conversations with referrers and patients, the reason I am very pro-cell therapy is for that outcome. It’s my job, as a service chief and as a cell therapy clinician, to figure out how I can do this in a way where it’s an easy process for the referrer to get the patients in and collected [while] coordinating holding, bridging, and post-care so the referrer is not having to do all this for every patient. That falls on me and my team to solve a lot of these problems and make their lives easier.
[It is also about] letting the referrer know that this is an open line of communication, that if they have a question—page me [or] call me; let’s talk about it. Not just in terms of [whether] this patient is eligible 1786896564, but 3 months down the line. I want them to know that my role in the care doesn’t end at day 15. If they have a patient who received a cell therapy 3 or 4 years down the road and think this could be something, call me. If it’s easiest, send [the patients] back to me; I’ll work everything up. I want to make the referrer’s life easier for giving the patient this opportunity to get into remission for years. [I am] reiterating that this is a partnership, a relationship, between the referrer and myself.
Richter: Yeah, and I love your sentiment about that early interaction. To me, that’s the big one. You said it best: some of the things we’re doing now, we’ve only been doing for months to a few years. Looking at CARTITUDE-5 [NCT04923893] and CARTITUDE-6 [NCT05257083], which I think you would agree are very likely to read out positively, there is going to come a day in the not-too-distant future where these therapies are approved in frontline therapy. Getting patients in front of a cellular therapist—whether or not it may be the right time, it may be never—but without that evaluation from someone who does it every day like you, I think this is a decision that needs to be made: to at least refer the patient early on and have that conversation very early in the course. To me, pretty soon, this is going to be part of our newly diagnosed strategy.
