CAR T-Cell Therapy

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In an interview with Targeted Oncology, Partow Kebriaei, MD, discussed the role of transplantation in patients with ALL following treatment with targeted cellular therapies, such as CAR T-cell therapy. She highlights the patient population that receives the most benefit from the use of CAR T-cell therapy and when transplant should be considered for these patients.

There are at least two dozen different B-cell maturation antigen-directed therapies being explored in clinical trials, Sham Mailankody, MBBS, told attendees at the 37 Annual CFS. Mailankody, an assistant attending physician at Memorial Sloan Kettering Cancer Center in New York, New York, highlighted the most promising anti-BCMA agents across several modalities, including CAR T-cell therapy, bispecific antibodies, and antibody-drug conjugates.

The initial pilot study of CTL019 in heavily pretreated CD19-positive hematologic malignancies demonstrated the feasibility of CAR T-cell therapy in patients with CLL. A presentation at the 2019 American Society of Gene & Cell Therapy Annual Meeting reported 2 cases of chemotherapy-resistant CLL, with ongoing follow- up at 8 years showing persistence of CAR-engineered T cells and sustained remission, as determined by flow cytometry and deep sequencing of immunoglobulin H rearrangements. 

Significant activity was observed when ibrutinib was administered concurrently with CD19-directed CAR T-cell therapy compared with separately in patients with high-risk relapsed/refractory chronic lymphocytic leukemia who had progressed on or were intolerant of ibrutinib. Data presented at the 15th International Conference on Malignant Lymphoma show a high response rate with this concurrent treatment.