CAR T-Cell Therapy for Myeloma | Why a Care Partner is Vital
Dr. Adriana Rossi, a myeloma specialist, explains the important role a care partner plays when a loved one is undergoing CAR T-cell therapy. Dr. Rossi outlines how CAR T treats myeloma and where this therapy fits into a treatment plan, and he explains who it could be right for.
Dr. Adriana Rossi is Director of the CAR T and stem cell transplant program at the Center for Excellence for Multiple Myeloma at Mount Sinai Health System in New York City. Learn more about Dr. Rossi.
See More from The Care Partner Toolkit: CAR T-Cell Therapy
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Transcript:
Jamie Forward:
Can you please give an overview of CAR T and how it works to treat myeloma?
Dr. Adriana Rossi:
Absolutely. CAR T are genetically engineered cells. So, we generally use the patient’s own T cells, modify them to make them special killers just for that patient’s myeloma.
And then, infuse them back into the patient over a process that I’m happy to go into in much more detail.
Jamie Forward:
So, where does CAR T-cell fit into a myeloma treatment plan?
Dr. Adriana Rossi:
Well, we originally had approvals in patients whose myeloma had come back three or four times. But, in 2024, now the two commercially available CAR T products, one ide-cel (Abecma) and the other cilta-cel (Carvykti), are now both approved in earlier lines. So, we actually could potentially be eligible for CAR T after your first relapse. As long as you’ve had a number of therapies up front.
Jamie Forward:
Okay. And so, when you say lines of treatment, that’s basically the number of therapies you’ve had so far?
Dr. Adriana Rossi:
Right. The number of times the myeloma has come back. So, regardless of whether it’s one drug or three drugs together – we now often use four drugs together.
But, we start off with a certain amount of myeloma and we treat it until it’s in remission as deep as we can. And then, we try to make that remission last as long as possible. Unfortunately, myeloma tends to eventually make its way back. That’s called the relapse. And then, you would start a new line of therapy. So, once the myeloma has come back after treatment, CAR T would be an option.
Jamie Forward:
So, can you walk us through the role of a care partner of a patient who’s receiving CAR T-cell therapy?
Dr. Adriana Rossi:
Absolutely. And, many patients and their families will have experience with stem cells. I think the first thing to keep in mind is this is nothing like a stem cell transplant. Yes, there are cells that are collected. There’s chemotherapy and the cells are infused in a hospital setting.
But, other than that, they are really very different experiences. And, given that’s what we would consider a long journey of CAR T through apheresis, which is the collection, then a bridging therapy while the cells are in manufacturing. Then, the hospital stay, and then the monitoring after. I think all of that is not a solo undertaking, and it really is essential to have one or more caregivers in that setting. It’s really important to have a second set of ears at the consultation so that that amount of new information, all the big words, how things go together, meeting people is a little less overwhelming. The whole getting ready for the CAR T. There are a lot of different doctors’ appointments. We like to check that hearts and lungs are healthy. A dentist needs to check you out and make sure there’s no infection. So, just an overwhelming process.
And, every step of the way, that’s going to be made easier if you have someone by your side.
