ArticleBlood advances2025
BCMA-directed CAR T-cell therapy in patients with multiple myeloma and CNS involvement.
Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Non-ICANS neurologic toxicity after BCMA CAR-T therapy: a systematic review and meta-analysis of 4630 patients with multiple myeloma.Blood advances · 2026Pooled it
- Infectious toxicities associated with bispecific antibodies and CAR-T Cells in multiple myeloma: a systematic review.Annals of hematology · 2026Pooled it
- Clinical course, risk factors, and therapeutic response in multiple myeloma with central nervous system involvement.Blood advances · 2026Article
- Cesni-cel (ARI0002h) in ultra-high-risk multiple myeloma with plasma cell leukaemia or central nervous system involvement.British journal of haematology · 2026Observational
- When Myeloma Escapes the Bone Marrow: Extramedullary Disease in the Immunotherapy Era.Cancers · 2026Review
- CAR T-Cell Therapy in Neurology: A Scoping Review of Neuro-Oncology, Autoimmune Diseases & Neurotoxicity.Annals of clinical and translational neurology · 2026Article
- Experiences and expert panel consensus on bridging therapy before anti-BCMA CAR-T cell therapy in multiple myeloma.Bone marrow transplantation · 2026Article
- Central nervous system multiple myeloma: An update for 2026.Annals of hematology · 2026Review
- Clinical Characteristics, Treatment Patterns, and Prognosis of Central Nervous System Involvement in Multiple Myeloma: A Multicenter Retrospective Study From China.Cancer medicine · 2026Article
- Breakthroughs and challenges of CAR-T cell therapy in treating hematologic malignancies of the central nervous system.Blood science (Baltimore, Md.) · 2026Review
- AMPAR immunization induces progressive autoimmune encephalitis with autoreactive B cells in the brain.bioRxiv : the preprint server for biology · 2026Article
- Cytokine-Engineered Chimeric Antigen Receptor-T Cell Therapy: How to Balance the Efficacy and Toxicity.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Elranatamab for Treatment of Multiple Myeloma With Central Nervous Involvement Refractory to Other Interventions.EJHaem · 2026Article
- Case Report: Central nervous system relapse treated with elranatamab after prior BCMA and GPRC5D directed therapies in relapsed/refractory multiple myeloma.Frontiers in oncology · 2026Article
- Efficacy of BCMA CAR-T cell therapy and subsequent strategies in refractory and relapsed plasma cell leukemia: a retrospective cohort study.Frontiers in immunology · 2026Article
- From Trials to Practice: A 2025 Review of Idecabtagene Vicleucel and Ciltacabtagene Autoleucel Efficacy Across Clinical Studies and Real-World Evidence.European journal of haematology · 2025Review
- Bispecific antibody therapy in CNS myeloma: Early evidence from a multicentre cohort.British journal of haematology · 2025Article
- From Bench to Bedside: Emerging Paradigms in CAR-T Cell Therapy for Solid Malignancies.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Therapeutic options for extramedullary involvement in multiple myeloma.Clinical and experimental medicine · 2025Review
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractWe investigated B-cell maturation antigen-directed chimeric antigen receptor T-cell (CAR-T) therapy in patients with relapsed or refractory multiple myeloma (MM) and central nervous system (CNS) involvement. Ten patients received either idecabtagene vicleucel (n = 6) or ciltacabtagene autoleucel (n = 4), where brain/cranial nerve and/or spinal cord involvement/leptomeningeal disease were evident on either magnetic resonance imaging (100%) and/or cerebrospinal fluid (40%). Eight patients had their CNS diagnosis before CAR-T therapy, and two were diagnosed within 14 days post-infusion. Seven received CNS-directed therapy during bridging before CAR-T therapy. There were no excess toxicities: no cytokine release syndrome grade ≥3; 10% immune effector cell-associated neurotoxicity syndrome (ICANS) grade 3; and no ICANS grade 4. Two patients experienced delayed but treatable neurotoxicity, with no reported parkinsonian side effects. The best overall response rate was 80% (≥70% very good partial response) and a 100% CNS response. With a median follow-up of 381 days, patients with CNS myeloma diagnosed before CAR-T therapy (n = 8) had a median overall survival and progression-free survival (PFS) of 13.3 and 6.3 months, respectively. Best outcomes were observed in 4 patients who had a response to bridging therapy, suggesting that optimizing pre-CAR-T therapy may be key for improved outcomes. Our study suggests that CAR-T therapy in patients with CNS MM is safe and feasible, and screening for CNS involvement before CAR-T therapy could be warranted in high-risk patients. The excellent initial response but relatively short PFS suggests consideration for post-CAR-T maintenance. Larger studies are needed to confirm these findings.
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Registered trials
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