A New Target for CAR T Cells Achieves Remission in Resistant Pediatric B-ALL
An early-stage trial in pediatric and young adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) has found that modifying the chimeric antigen receptor (CAR) T cells to target the CD22 receptor achieved remission.
An early-stage trial in pediatric and young adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) has found that modifying the chimeric antigen receptor (CAR) T cells to target the CD22 receptor achieved remission. The study, a collaboration between the Stanford University School of Medicine and the National Cancer Institute (NCI), has been published in Nature Medicine.
CAR T-cell treatments have seen significant progress over the last year, and the first CAR T product, tisagenlecleucel (Kymriah), manufactured by Novartis, received
The current study enrolled 21 children and young adults (7 to 30 years) with B-ALL, 17 of whom had previously failed on CD19-directed immunotherapy. Each patient had undergone at least 1 bone marrow transplant and a significant portion of patient who had previously received CD19-taregetd treatment no longer expressed CD19 on their cancer cells.
Following administration of varying doses of anti-CD22 CAR T cells, complete remission was observed in 11 of 15 patients (73%) who received at least 1 million CD22-CAR T cells per kilogram of body weight—the median duration of remission was 6 months. Relapse, the authors wrote, was associated with a reduced CD22 site density, which allowed CD22+ cells to escape being targeted and destroyed by CD22-CAR T cells.
“The take-home message is that we've found another CAR T-cell therapy that displays high-level activity in this phase 1 trial,” Crystal Mackall, MD, associate director of Stanford’s Cancer Institute and the director of the Parker Institute for Cancer Immunotherapy at Stanford, said in a
Follow-up studies are being designed by Mackall and co-author Terry Fry, MD, a pediatric hematologist and oncologist at the NCI, to address this question.
Reference
Fry TJ, Shah NN, Orentas RJ, et al. CD22-targeted CAR T cells induce remission in B-ALL that is naive or resistant to CD19-targeted CAR immunotherapy [published online November 20, 2017]. Nat Med. doi: 10.1038/nm.4441.
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