5 research outputs found

    CAR-T-Cell Therapy in Multiple Myeloma: B-Cell Maturation Antigen (BCMA) and Beyond

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    Significant progress has been achieved in the realm of therapeutic interventions for multiple myeloma (MM), leading to transformative shifts in its clinical management. While conventional modalities such as surgery, radiotherapy, and chemotherapy have improved the clinical outcomes, the overarching challenge of effecting a comprehensive cure for patients afflicted with relapsed and refractory MM (RRMM) endures. Notably, adoptive cellular therapy, especially chimeric antigen receptor T-cell (CAR-T) therapy, has exhibited efficacy in patients with refractory or resistant B-cell malignancies and is now also being tested in patients with MM. Within this context, the B-cell maturation antigen (BCMA) has emerged as a promising candidate for CAR-T-cell antigen targeting in MM. Alternative targets include SLAMF7, CD38, CD19, the signaling lymphocyte activation molecule CS1, NKG2D, and CD138. Numerous clinical studies have demonstrated the clinical efficacy of these CAR-T-cell therapies, although longitudinal follow-up reveals some degree of antigenic escape. The widespread implementation of CAR-T-cell therapy is encumbered by several barriers, including antigenic evasion, uneven intratumoral infiltration in solid cancers, cytokine release syndrome, neurotoxicity, logistical implementation, and financial burden. This article provides an overview of CAR-T-cell therapy in MM and the utilization of BCMA as the target antigen, as well as an overview of other potential target moieties

    Obesity Is Associated With Worse Overall Survival in Women With Low-Grade Papillary Serous Epithelial Ovarian Cancer

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    OBJECTIVE: To evaluate prognostic risk factors for survival in women with low grade serous epithelial ovarian cancer (LGSC). METHODS: A multicenter retrospective analysis of patients with LGSC was conducted. Potential epidemiologic risk factors evaluated included obesity, age, parity, race, smoking, oral contraceptive pill and/or hormonal replacement therapy use, and previous hysterectomy or surgery on fallopian tubes and/or ovaries. Additional factors included stage, extent of debulking, residual disease, and disease status. RESULTS: Eighty-one patients were identified, and pathological diagnosis was independently confirmed. Median age of diagnosis was 56 years (range: 21 to 86). Thirty-four percent were obese, and 80% had optimally debulked disease. Forty-six percent were alive, 14% with disease; while 25% were dead of disease; 2% died of intercurrent disease; and 27% had an unknown status. In a univariate analysis, optimal surgical debulking was associated with improved PFS (p=0.01), DSS (p=0.03), and OS (p<0.001 and BMI with worse OS (p=0.05). On multivariate analysis, obesity (HR=2.8; 95% CI=1.05-7.3; p=0.04) and optimal tumor debulking (HR=0.05; 95% CI=0.008-0.29; p=0.001) were a significant predictor of OS. CONCLUSIONS: In a multivariate analysis, obesity and optimal tumor cytoreduction were significant predictors of OS. However, obesity was not associated with worse DSS, suggesting that mortality of obese patients with LGSC may result from other co-morbidities. Interventions addressing obesity may improve survival for women diagnosed with LGSC and further study is warranted to address the role of obesity in LGSC
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