Zachary Crees, MD, on the Potential of Cell Therapy to Treat or Prevent Viral Infections After HSCT

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The assistant clinical director of the Center for Gene and Cellular Immunotherapy at Washington University in St. Louis discussed Atara Biotherapeutics' tabelecleucel and AlloVir’s posoleucel.

“I think I think the future for posttransplant viral complications and management of those viral complications is certainly going to make use of all of the antiviral therapies that we have at our disposal, but I think that can be improved upon by the implementation of viral-specific cellular therapies. I think where we need to learn more about this is how best to use them and whether prevention is the right strategy or using those therapies in the treatment of poorly controlled or refractory viral infections is maybe more suited.”

Allogeneic hematopoietic stem cell transplant (HSCT) is a standard of care therapy for a wide range of diseases, from hematologic cancers to some inherited disorders. Although HSCT can have a transformative impact on patients, it carries several risks, such as graft versus host disease (GvHD) and a higher risk of viral infections after transplant. Ironically, advances in conditioning therapies and prophylaxis meant to reduce the risk of GvHD via immunosuppression have actually increased the risk patients face from viral infections after receiving HSCT. Although currently available antiviral therapies are used to combat such infections, there is room for improvement. Some companies and institutions are evaluating cell therapy as a modality to potentially address this unmet need. One such candidate is Atara Biotherapeutics' tabelecleucel, an allogeneic Epstein–Barr virus (EBV)-specific T-cell immunotherapy for patients with relapsed or refractory or treatment-naïve Epstein-Barr virus-positive post-transplant lymphoproliferative disease (EBV+ PTLD) following solid organ transplant or hematopoietic cell transplant, which is currently being evaluated in the phase 3 ALLELE clinical trial (NCT03394365). Another is AlloVir’s posoleucel, an investigational virus-specific T-cell (VST) therapy that has been evaluated across several clinical trials for multiple indications.

CGTLive® sat down with Zachary Crees, MD, the assistant clinical director of the Center for Gene and Cellular Immunotherapy at Washington University in St. Louis, to learn more about the aforementioned viral risks and the cell therapies that could potentially treat them. He will be presenting about this topic in a talk entitled “Viral Infections Post-Transplant and Updates in Anti-Viral Cytotoxic T-Cell Therapies” at the 2024 Tandem Meetings |Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR, held in San Antonio, Texas, February 21-24, 2024. The talk will take place on February 23 at 11:00 AM CT.

REFERENCES
1. Crees ZD. Viral infections post-transplant and updates in anti-viral cytotoxic T-cell therapies. Presented at: 2024 Tandem Meetings, February 21-24, San Antonio, Texas.
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