Dr. Duncan on the Use of CAR T-Cell Therapy in Pediatric ALL

Christine N. Duncan, MD, senior physician, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the use of CAR T-cell therapy in the treatment of pediatric patients with acute lymphocytic leukemia (ALL).

The FDA label for the use of CAR T-cell therapy in pediatric oncology is indicated for patients with relapsed/refractory high-risk ALL. With the FDA approval of CAR T-cell therapy, physicians continue to compound the success of treatment for pediatric patients, says Duncan. In the early 1970s, the overall survival (OS) rate was 58%. Now, the OS rate is approximately 90%.

Although the survival rate is high, a percentage of patients will relapse or become refractory to their initial therapy, says Duncan. These patients have a poor prognosis with a survival rate closer to 20%, she adds. Notably, a lot of the work regarding CAR T-cell therapy stemmed from initial research targeting CD19 in pediatric oncology. Since its expansion to adult patients and other tumor types, investigators are learning more about obstacles with the therapy as well as patient selection, Duncan concludes.