Andre Goy, MD, MS, the Chief of the Division of Lymphoma at the John Theurer Cancer Center, discusses the apparent effectiveness of CD19-targeted chimeric antigen receptor (CAR)-modified T cells as a treatment for patients with various types of lymphoma.
Several versions of CAR-modified T cells exist, each with different side effects and constructs. However, when the evidence on each is taken together, the proof of principle is quite amazing, Goy believes.
The treatments can be utilized in a variety of settings. In some cases, the T cells are modified in the relapsed setting, following an allogeneic transplant. Additionally, autologous T cells can be utilized in the case of aggressive lymphomas, where there is only a small chance for relapse. In some studies, these treatments were used as a consolidative therapy, post-transplant, Goy states.
Ultimately, this will be a very important tool in lymphoma, Goy believes. These engineered T cell therapies are the ideal vaccines, since they are a cell therapy that persists to fights against recurrence, Goy believes. In general, these agents work by depleting CD19-positive B cells, which make antibodies. As a result of this mechanism, most patients will require lifetime intravenous immunoglobulin.
As research moves forward, Goy hopes the technology will evolve to provide further control for the lifespan of the T cells. These treatments hold the potential to completely change the treatment landscape in lymphoma, Goy states.
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