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Homozygous BCMA gene deletion in response to anti-BCMA CAR T cells in a patient with multiple myeloma
Ist Teil von
Nature medicine, 2021-04, Vol.27 (4), p.616-619
Ort / Verlag
New York: Nature Publishing Group US
Erscheinungsjahr
2021
Beschreibungen/Notizen
B cell maturation antigen (BCMA) is a target for various immunotherapies and a biomarker for tumor load in multiple myeloma (MM). We report a case of irreversible BCMA loss in a patient with MM who was enrolled in the KarMMa trial (
NCT03361748
) and progressed after anti-BCMA CAR T cell therapy. We identified selection of a clone with homozygous deletion of
TNFRSF17
(
BCMA
) as the underlying mechanism of immune escape. Furthermore, we found heterozygous
TNFRSF17
loss or monosomy 16 in 37 out of 168 patients with MM, including 28 out of 33 patients with hyperhaploid MM who had not been previously treated with BCMA-targeting therapies, suggesting that heterozygous
TNFRSF17
deletion at baseline could theoretically be a risk factor for BCMA loss after immunotherapy.
Biallelic loss of
BCMA
caused a patient with multiple myeloma to relapse after anti-BCMA CAR T cell treatment. Baseline heterozygous
BCMA
deletions might be a risk factor for this form of resistance.