Dr. Grupp on the Optimal Setting of CAR T-Cell Therapy in ALL

Stephan Grupp, MD, PhD, director, Cancer Immunotherapy Program, director, Translational Research for the Center for Childhood Cancer Research, medical director, Stem Cell Laboratory, Children’s Hospital of Philadelphia, discusses the placement of chimeric antigen receptor (CAR) T-cell therapy in the treatment of patients with acute lymphoblastic leukemia (ALL).

Currently, the CAR T-cell therapy tisagenlecleucel (Kymriah) has been approved by the FDA for the treatment of pediatric and young adult patients with relapsed or refractory ALL; however, physicians are hoping to bring it into earlier lines of therapy. In the past 5 or 6 years, referring physicians have been calling specialists earlier, notes Grupp. Patients who are referred early often have a lower disease burden, he adds.

The Children's Oncology Group is set to launch an international study to evaluate whether CAR T-cell therapy can be used as frontline therapy in patients who have not relapsed; these are high-risk patients who still have minimal residual disease after receiving 2 cycles of chemotherapy. Earlier introduction of CAR T-cell therapy may obviate the need for transplant, explains Grupp. The trial is set to open in the next month or two.