clarithromycin + lenalidomide + dexamethasone + autologous BCMA-directed CAR T-cells

This combination therapy consists of three small-molecule drugs—clarithromycin (a macrolide antibiotic), lenalidomide (an immunomodulatory agent), and dexamethasone (a synthetic glucocorticoid)—together with autologous B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T-cell therapy. The BiRd regimen (clarithromycin, lenalidomide, dexamethasone) is established for the treatment of multiple myeloma and has demonstrated high response rates in both newly diagnosed and relapsed/refractory settings[1][4]. Clarithromycin may enhance the efficacy of lenalidomide and dexamethasone by modulating immune responses, inhibiting CYP3A to increase corticosteroid exposure, reducing IL-6 levels, and directly affecting myeloma cell survival[4]. Autologous BCMA-directed CAR T-cells are engineered from a patient’s own T cells to express a receptor targeting BCMA on malignant plasma cells; upon infusion, these cells bind to BCMA-expressing myeloma cells and induce their destruction through cytotoxic immune mechanisms[6]. This multi-modal approach aims to maximize anti-myeloma activity by combining direct cytotoxicity with immunomodulation. Developers: Bristol Myers Squibb/Janssen/Legend Biotech

Brand names

AbecmaCarvykti

Other names

clarithromycin/lenalidomide/dexamethasone/BCMA CAR-Tcar-BiRd regimen