Renier Brentjens, MD, PhD, on Autologous Versus Allogeneic CAR-T for the Near-Term Future

This is the second part of an interview with Renier Brentjens, MD, PhD. For the first part, click here.

“...[T]here's certainly virtue to having off-the-shelf products. It's probably going to be cheaper, it's probably going to be easier, and provide more access to more patients for this technology, but to start working on the seat belts and the air conditioning before you've optimized the engine, to me at least, philosophically doesn't make sense.”

Over the past 5 to 10 years, chimeric antigen receptor T-cell (CAR-T) therapy has established itself as an effective treatment modality for blood cancers, but it has become clear that new innovations are needed to tackle solid tumor indications. Currently, all FDA-approved CAR-T products for hematologic malignancy indications are based on the use of autologous, alpha-beta (αβ) T-cells. One approach is to apply these cells with modifications, such as additional genetic engineering in the form of armored CAR T-cells, to the problem of solid tumors. Another approach is to utilize different cell types, such as gamma-delta T-cells or natural killer (NK) cells, as the basis for CAR cell therapy, or to use allogeneic αβ T-cells rather than autologous ones. Some companies and institutions are even combining allogeneic approaches with nontraditional cell types.

In an interview with Renier Brentjens, MD, PhD, the chair of the department of medicine and the deputy director at Roswell Park Comprehensive Cancer Center, on the topic of future innovations in the field of CAR-T, CGTLive® asked Brentjens for his view on the autologous versus allogeneic debate in oncology cell therapy. Brentjens expressed the opinion that although alternative approaches have potential advantages and rationales behind them, the field ought to firmly establish the efficacy of autologous, αβ CAR T-cells in solid tumors before bringing additional variables into the mix. He utilized the analogy of perfecting the engine of an automobile before worrying about modifications to things such as the air condition or stereo in order to make his point.