A phase 1 study evaluated anitocabtagene autoleucel (anito-cel), a BCMA-directed CAR T-cell therapy with a novel d-domain binder, in 38 patients with heavily pretreated relapsed or refractory multiple myeloma. The trial reported a 100% overall response rate, with 79% achieving complete response, median progression-free survival of 30.2 months, and 36-month overall survival of 65%; severe cytokine release syndrome and neurotoxicity were rare. The authors also reported that in vitro comparisons showed the ddBCMA binder produced less cytokine release than a dual-VHH binder corresponding to ciltacabtagene autoleucel's published sequence, without off-target cytotoxic effects.
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