A One-Time CAR-T Treatment Is Changing the Conversation on Myeloma Cure

For years, treatment for multiple myeloma focused on controlling the cancer and extending the periods when it stayed in check. Now, doctors are speaking more cautiously about something that was rarely mentioned before, the possibility of cure for some patients, driven by newer therapies that can produce deeper and longer-lasting remissions.

The article follows 64-year-old Lior Yonatan Haimov of Hod HaSharon, an Ironman athlete who developed persistent back pain and was diagnosed with multiple myeloma, a blood cancer that begins in plasma cells in the bone marrow. Haimov said the diagnosis was a turning point: "The diagnosis was that I had cancer. That was the turning point." He added that his goals were to understand why it happened and find the fastest, least damaging treatment. In Israel, hundreds of new myeloma patients are diagnosed each year.

Dr. Yulia Waxman, head of the Multiple Myeloma and Rare Plasma Cell Diseases Center at Davidoff Center, Beilinson, said treatment has been transformed in recent years. "For the first time in this disease, we can even talk about a potential cure in some patients," she said, while stressing that myeloma is still generally considered a chronic disease. She said the key shift is the move toward very deep responses, sometimes with sensitive tests showing no active disease. One of the most striking advances is CAR-T, a personalized, one-time immunotherapy that takes a patient’s T cells, engineers them in the lab to recognize a protein on myeloma cells, and returns them to attack the cancer. Unlike a stem-cell transplant, CAR-T uses a low-dose one-time chemotherapy step and does not require ongoing maintenance therapy.

Haimov said he waited months for a research-trial answer and feared he was running out of time after losing his spouse to cancer. Two and a half years after treatment, he says, "Today I am clean, healthy and strong," and has returned to sport. He now works in personal and business coaching and says the illness helped him redefine his purpose. Waxman said that for suitable patients, a one-time treatment can mean a long remission, a return to work and family life, and less time revolving around hospital visits, though the treatment is not for everyone and still requires close follow-up.