HKUMed Pioneers CAR-T Cell Therapy for End-Stage Multiple Myeloma in Hong Kong Using Advanced Mainland Cell Product

A clinical team from the Department of Medicine at the University of Hong Kong’s LKS Faculty of Medicine (HKUMed), in partnership with Queen Mary Hospital, has successfully introduced CAR-T cell therapy for blood cancers. The team recently treated the first myeloma patient with this innovative therapy, achieving excellent results and no severe complications (see patient case details in Appendix A). This milestone expands treatment options for myeloma patients who have not responded to conventional therapies, significantly advancing healthcare in Hong Kong. Notably, this marks the first use of an advanced CAR-T cellular product manufactured in mainland China within Hong Kong, potentially paving the way for broader applications of innovative therapies from the mainland to benefit more patients in the future.

The research team, led by Professors Kwong Yok-lam (front right) and Eric Tse Wai-choi (front left), successfully utilises BCMA CAR-T cells from the mainland to cure multiple myeloma.

Background

Myeloma is a malignant disorder affecting plasma cells, primarily impacting individuals in their forties and fifties, although younger patients are also susceptible. It leads to severe complications such as anemia, bone damage, and kidney failure, often resulting in death.

The current standard treatment for myeloma includes the use of targeted agents, sometimes in conjunction with chemotherapy, followed by autologous hematopoietic stem cell transplantation. Despite this, many patients experience relapses. For those who relapse or do not respond to initial treatment, options are limited. Current alternatives, including bispecific antibodies and other targeted drugs, offer only temporary relief. For relapsed patients who respond poorly to traditional therapies, the prognosis is often terminal.

CAR-T cell therapy represents a groundbreaking approach that enables patients to leverage their immune systems to combat cancer. This therapy involves genetically modifying T-lymphocytes to express a chimeric antigen receptor, targeting specific antigens present on cancer cells. In standard CAR-T therapy, these T-lymphocytes are autologous, derived from the patient, and have been effective in treating various blood cancers, including leukemia, lymphomas, and myeloma.

Queen Mary Hospital became the first institution in Hong Kong to provide CAR-T cell therapy in 2021, successfully treating over 60 patients with diverse blood cancers, making it the largest cohort of CAR-T treated patients in the region.

Research Methods and Findings

The treatment process initiates with the collection of T-lymphocytes from the patient’s peripheral blood through a procedure called apheresis. These T-lymphocytes are then sent to a manufacturing facility, where the CAR construct is integrated. While the genetically modified CAR-T cells are being prepared, the patient undergoes chemotherapy for lymphodepletion to eliminate existing lymphocytes. Once lymphodepletion is complete, CAR-T cells are reinfused back into the patient.

The CAR-T cells developed for myeloma specifically target B-cell maturation antigen (BCMA). The research team utilized BCMA CAR-T cells sourced from a mainland manufacturer, which has been in use since 2020 and received approval from the National Medical Products Administration in 2023. This marks the first utilization of this product outside the mainland.

Professors Kwong Yok-lam (left) and Eric Tse Wai-choi state that the team will continue to seek and develop advanced clinical treatment techniques to benefit more patients in Hong Kong.

Significance of the Treatment

“Currently, Queen Mary Hospital is the only facility in Hong Kong providing CAR-T cell immunotherapy for myeloma, with a pilot program designed to treat five to ten myeloma patients annually,” stated Professor Kwong Yok-lam, Chair Professor of the Department of Medicine at HKUMed.

Professor Eric Tse Wai-choi, Associate Dean (Research) and Clinical Professor, noted, “BCMA CAR-T cell therapy could transform myeloma treatment in Hong Kong, serving as one of the most effective salvage options available. It offers a potentially life-saving solution for patients who do not respond to standard therapies or who relapse after autologous stem cell transplantation.”

The introduction of BCMA CAR-T cell therapy for these patients signifies the first application of advanced clinical technology from the mainland in Hong Kong. It demonstrates how cutting-edge therapies and technologies from the mainland can effectively benefit patients in Hong Kong and opens the door for increased access to innovative treatment strategies from the mainland.

About the Research Team

The research team includes Professor Kwong Yok-lam, Chair Professor; Professor Eric Tse Wai-choi, Associate Dean (Research) and Clinical Professor; Dr. Joycelyn Sim Pui-yin, Dr. Gloria Hwang Yu-yan, and Dr. Thomas Chan Sau-yan, Honorary Associate Professors, along with Dr. Karen Tang Hoi-ki, Honorary Clinical Assistant Professor at the Department of Medicine, HKUMed.