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Orvacabtagene autoleucel is an investigational, autologous chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA), a protein highly expressed on malignant plasma cells in multiple myeloma. The product consists of a patient’s own CD4+ and CD8+ T lymphocytes that are genetically modified ex vivo using a lentiviral vector to express a CAR with a fully human single-chain variable fragment specific for human BCMA, fused to the co-stimulatory domain 4‑1BB (CD137) and the CD3-zeta signaling domain. Upon infusion, these engineered T cells recognize and kill BCMA-expressing tumor cells through immunologic cytotoxicity. Orvacabtagene autoleucel was developed by Juno Therapeutics (a Bristol Myers Squibb company), with early research contributions from Fred Hutchinson Cancer Research Center and Memorial Sloan-Kettering Cancer Center. It was evaluated in relapsed/refractory multiple myeloma in the EVOLVE phase I/II clinical trial but its development has been discontinued[1][3][4][5][6][8].
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