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Myeloma Immune Map Predicts Relapse as Bispecific CAR T Counters BCMA Loss

Researchers say the early-stage findings could sharpen prognosis to direct immunotherapies to patients most likely to benefit.

Overview

  • A Nature Cancer study mapped nearly 1.4 million bone marrow cells from 337 newly diagnosed patients, defining immune signatures linked to rapid relapse and poorer survival.
  • Investigators identified inflammatory signaling between tumor and immune cells and a dysfunctional, suppressive T cell subset associated with aggressive disease.
  • Adding immune features to existing genomic and clinical risk models improved stratification, with authors calling for development of practical immune-based tests.
  • Separately, a Berlin-led team reported bispecific BAFF-R/BCMA CAR T cells that killed myeloma cells in lines and patient-derived marrow even when BCMA was absent.
  • Researchers estimate roughly 5–30% of patients could benefit from the dual-target approach, which remains preclinical and will require initial safety and efficacy trials.