Ciltacabtagene Autoleucel

Genetic engineering of a patient's own T cells produces ciltacabtagene autoleucel, a chimeric antigen receptor therapy directed at BCMA, a protein expressed on myeloma plasma cells. The modified cells are reinfused and recognise that antigen directly, and in heavily pretreated disease the approach has produced deep and durable remissions. Its place in therapy is relapsed or refractory multiple myeloma after several previous lines. The characteristic hazards belong to the cellular class rather than to conventional pharmacology: cytokine release syndrome and neurotoxicity can be severe and require specialised monitoring, which restricts administration to centres equipped for it. The product is classified as a gene therapy and has completed the final phase of clinical development.