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IL-18-secreting CAR T cells are an engineered cell therapy designed to treat multiple myeloma, particularly cases with low antigen expression. These chimeric antigen receptor (CAR) T cells are modified to target B-cell maturation antigen (BCMA) and B-cell activating factor receptor (BAFF-R) simultaneously. Additionally, they are engineered to secrete the proinflammatory cytokine interleukin-18 (IL-18). This dual approach aims to overcome the challenge of weak antigen expression on myeloma cells by enhancing T-cell activity, promoting interferon-gamma production, reprogramming the bone marrow microenvironment through type-I/II interferon signaling, and activating macrophages to mediate anti-myeloma activity. The combination of multiantigen targeting and engineered IL-18 secretion has demonstrated the ability to eliminate myeloma with weak antigen expression in preclinical models.
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