fludarabine + cyclophosphamide + BCMA-GPRC5D CAR-T cells

This is a combination therapy consisting of two chemotherapeutic agents, fludarabine and cyclophosphamide, used as a lymphodepleting regimen prior to the infusion of dual-targeted chimeric antigen receptor T (CAR-T) cells engineered to recognize both B-cell maturation antigen (BCMA) and G protein–coupled receptor class C group 5 member D (GPRC5D). Fludarabine and cyclophosphamide are administered to reduce the number of normal T-cells in the patient, creating space for the infused CAR-T cells and enhancing their expansion, persistence, and anti-tumor activity[1][2][3][4][5][7][8]. The BCMA-GPRC5D CAR-T cells are genetically modified autologous T-cells designed to target multiple myeloma by recognizing both BCMA and GPRC5D antigens on malignant plasma cells. This dual targeting aims to overcome resistance mechanisms such as antigen loss or low expression that can occur with single-antigen targeted therapies[6]. The primary indication for this combination is relapsed/refractory multiple myeloma.