Dr. Shah on Differences Between Anti-CD19 CAR T-Cell Therapies

Nirav N. Shah, MD, assistant professor, Medical College of Wisconsin, discusses the differences between anti—CD19 CAR T-cell therapies.

CAR T-cells are a biological product, meaning that any variation within the construct of the CAR T cell could theoretically impact safety, efficacy, and toxicity, explains Shah. One of the FDA-approved products is the 4-1BB construct, and there are properties of that product that differ from the other FDA-approved product, which is a CD28 CAR T-cell product. Without a head-to-head trial, it is difficult to make cross comparisons between the 2. However, there may be potential differences within the toxicity profiles of these products, says Shah.

At the 2018 ASH Annual Meeting, updated data were presented on the anti-CD19 CAR T-cell product axicabtagene ciloleucel (axi-cel; Yescarta). Investigators now have a 2-year update, which shows that approximately 39% of patients remained in remission. This shows that CAR T-cell therapy is both effective and durable in certain patients. With longer follow-up, investigators hope to see more durable responses, Shah concludes.