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ASH 2018: CAR T-Cell therapies show durable responses, new research also explores combination therapies to extend and enhance treatment responses

Chimeric antigen receptor (CAR) T-cell therapies have quickly shifted the treatment paradigm for many people with several types of aggressive blood cancers, in whom treatment options have been woefully limited. 

Five studies being presented today at the 60th American Society of Haematology (ASH) Annual Meeting and Exposition spotlight the long-term effectiveness of these therapies in some patients, analyse how combination therapies might affect treatment responses, and examine if transplantation following CAR T-cell therapy affects remission rate.

CAR T-cell therapies are designed by harvesting a patient’s own T cells (the immune system’s primary cancer-killing cells), reengineering them to target specific proteins on the surface of cancer cells, and reintroducing the modified T cells back into the patient’s immune system.

“These are transformative therapies and we’re seeing their expanding value in terms of giving patients who essentially ran out of options an opportunity to live,” said press briefing moderator, Joseph Alvarnas, MD, of the City of Hope in California. “At the same time, we’re identifying the limitations of these therapies. For example, CAR T cells may stop working in some patients for various reasons, which has prompted researchers to ask what combination therapies could be used to extend the benefits of treatment.”

In two of the studies, longer-term follow-up analyses of the ELIANA and JULIET trials further demonstrate sustained responses to T cells designed to target the CD-19 protein, which is frequently expressed on malignant lymphoma cells.

Two other studies investigate combining CAR T-cell therapies with additional treatments — the first leverages a second oncologic agent, ibrutinib, while the other analyses the addition of a checkpoint inhibitor — to determine whether their use might enhance the effect of and sustained response to CAR T.

In the final study, researchers evaluate the effect of stem cell transplantation on long-term outcomes after CD19 CAR T-cell therapy for paediatric patients with acute lymphocytic leukaemia.

Source: ASH



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