Allogeneic chimeric antigen receptors (CARs) as an "off-the-shelf" therapy in multiple myeloma

The success of autologous chimeric antigen receptor (CAR)-T cells has changed the treatment landscape in relapsed and refractory multiple myeloma (MM) resulting in potential movement of CAR-T cells to the frontline treatment setting. However, one of the greatest weaknesses of this therapy is its autologous nature, which makes it time-consuming, labor intensive, and dependent on the patient's T cell fitness. The development of allogeneic CARs is critical to overcome these challenges and provide patients with an off-the-shelf alternative that is readily available. This review will investigate the current landscape and future perspectives of allogeneic CAR research in MM, exploring both pre-clinical research and active clinical trials. More specifically, it will focus on the advantages and disadvantages of various CAR cellular candidates including CAR-T, CAR-NK, and CAR-iNKT cells, among other more novel candidates.