ciltacel

cilta-cel, or ciltacabtagene autoleucel (brand name Carvykti), is an autologous chimeric antigen receptor T-cell (CAR-T) therapy directed against BCMA, a protein expressed on most multiple myeloma cells. It was developed by Legend Biotech and Janssen Biotech and is approved for adults with relapsed or refractory multiple myeloma after prior lines of therapy, in several regions including the United States and the European Union.

The therapy uses a patient's own T cells collected by leukapheresis, engineered in the laboratory to express a CAR comprised of a BCMA-targeting tandem domain, then expanded and infused after a lymphodepleting chemotherapy regimen. Some patients may receive bridging therapy to bridge to infusion. Manufacturing typically takes a few weeks.

Clinical trials, notably CARTITUDE-1, showed high response rates and deep remissions in heavily pretreated patients. The therapy is given as a single infusion; duration of response can vary; bridging therapy is optional in some cases.

Safety: Common adverse events include cytokine release syndrome and neurotoxicity (ICANS), as well as cytopenias, infections, and hypogammaglobulinemia. Severe events require specialized care; hospitalization is common for monitoring post-infusion. Patients are monitored closely for signs of CRS, ICANS, and other hematologic or infectious complications.

Regulatory status: approvals in major markets; administered in certified centers with CAR-T experience; ongoing research includes earlier-line use and combinations, and long-term outcomes. cilta-cel is one of several BCMA-targeted CAR-T therapies used to treat multiple myeloma, reflecting the growing role of cellular immunotherapy in this disease.