CAR-T cell therapy for multiple myeloma: a practical toolkit for treatment in Brazil

Afiliação

 (1)    Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil; Clínica São Germano, São Paulo, Brazil.

(2)    Clinica Universidad de Navarra, IDISNA, Pamplona, Spain.

(3)    A.C. Camargo Cancer Center, São Paulo, SP, Brazil.

(4)    Hospital Universitário Professor Edgar Santos da Universidade Federal da Bahia (HUPES), Salvador, BA, Brazil; Rede D'or Oncologia, Salvador, Brazil.

(5)    Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

(6)    Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Oncologia Américas, Rio de Janeiro, Brazil.

(7)    Clinica Universidad de Navarra, IDISNA, Pamplona, Spain. Electronic address: paurodriguez@unav.es.

Resumo

Introduction: Chimeric antigen receptor T (CAR-T) cell therapy is an emerging treatment option for relapsed/refractory multiple myeloma (RRMM) that is a multi-step process involving various stakeholders. Appropriate education on the practical logistics is therefore paramount to ensure treatment success. Methods: A group of key opinion leaders met to explore the key elements of setting up and running a CAR-T center in Brazil. For each step in the CAR-T cell therapy process, the experts agreed on basic requirements, gave their key recommendations from practical experience, and considered any remaining unanswered questions. Results: This paper presents best-practice recommendations and advice on how to overcome common challenges for each step in the CAR-T cell therapy process, with a focus on the current situation in Brazil. Key themes throughout the process are collaboration within the multidisciplinary team and with the referring physician, along with communication and education for patients and their caregivers. Conclusion: We believe that the expert insights presented in this paper, in particular on optimal patient selection and timing of CAR-T cell therapy, will deepen understanding of the CAR-T process and aid implementation of this novel therapy for patients with RRMM in Brazil.