Dr. Davids on the Future of CAR T-Cell Therapy in CLL

Matthew S. Davids, MD, MMSc, director of clinical research in the Lymphoma Program and a medical oncologist with Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School, discusses the future of CAR T-cell therapy in chronic lymphocytic leukemia (CLL).

CAR T-cell therapy has been more of a challenge to develop for CLL compared with other diseases, such as diffuse-large B cell lymphoma, says Davids. In patients with CLL, T cells are dysfunctional because of the T-cell function suppression commonly observed in the disease. Although CAR T cells can be effective in some patients with CLL, including those who are refractory to other therapies, there is room for improvement, according to Davids.

Some of the emerging combination approaches have started to emerge, says Davids. The addition of ibrutinib (Imbruvica) to CAR T-cell therapy, for example, may help the T-cell effector function be more potent, explains Davids.

If these products receive approval, this approach will might be indicated for a more heavily pretreated population, specifically those who have progressed following multiple novel agents or particularly those with TP53 aberrations, explains Davids. CAR T-cell therapies may potentially replace transplant for some patients, adds Davids.

As this modality becomes more effective in CLL, based on various combination approaches and an improved toxicity profile, the hope is that CAR T-cell therapy can be moved into earlier lines of treatment. CAR T-cell therapy could have an important role in the future of CLL treatment, concludes Davids.