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Emerging CAR T-Cell Therapies

Panelists: Anas Younes, MD, Memorial Sloan Kettering Cancer Center
Published: Friday, May 25, 2018



Transcript: 

Anas Younes, MD: So, when we talk about CAR T cells, it’s a platform. There are 3 different company-sponsored products. There are similarities and some differences. The major similarity between Kite, Novartis, and Juno is that they all target CD19-positive B cells, including the diffuse large B-cell lymphoma.

So, the target is the same, but what happens inside the cell and under the surface with the signaling molecules and the way they’re prepared, whether it’s unfractionated T cells or fractionated T cells, can vary among these different products. But the principle is the same. We’re bringing patients’ own T cells, immune cells, to the site of a cancer cell that expresses CD19, get the T cells activated, and kill the tumor cells.

Axi-cel (axicabtagene ciloleucel), which is the Kite product, is the first one to be approved by the FDA based on the ZUMA-1 trial; more than 100 patients, about an 80% overall response rate, and about a 40% complete response rate lasting for up to a year. Very exciting. How many of these complete responses will be durable, let’s say, 5 years from now? We don’t know, but it’s encouraging that the complete response rate did not decrease significantly between 6 months and 1 year. So, we expect some of these patients will remain in complete response for many years. And although it’s unheard of to talk about a cure at this point, I think most of us would not be surprised that some of these patients probably will be cured with CAR T cells, including the axi-cel and others, probably.

So, it’s really new now, the approval, and only specialized centers are allowed to use it because of safety and preparation, expertise. With time, I think this should be available to other centers. But for now, it’s restricted to select centers, including our own center, Memorial Sloan Kettering. And, yes, we’re starting to use it commercially on label. I think as of now, we treated 6 patients and it’s with the clinical trial, and you see responses as have been seen in the clinical trial.

Transcript Edited for Clarity 
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Transcript: 

Anas Younes, MD: So, when we talk about CAR T cells, it’s a platform. There are 3 different company-sponsored products. There are similarities and some differences. The major similarity between Kite, Novartis, and Juno is that they all target CD19-positive B cells, including the diffuse large B-cell lymphoma.

So, the target is the same, but what happens inside the cell and under the surface with the signaling molecules and the way they’re prepared, whether it’s unfractionated T cells or fractionated T cells, can vary among these different products. But the principle is the same. We’re bringing patients’ own T cells, immune cells, to the site of a cancer cell that expresses CD19, get the T cells activated, and kill the tumor cells.

Axi-cel (axicabtagene ciloleucel), which is the Kite product, is the first one to be approved by the FDA based on the ZUMA-1 trial; more than 100 patients, about an 80% overall response rate, and about a 40% complete response rate lasting for up to a year. Very exciting. How many of these complete responses will be durable, let’s say, 5 years from now? We don’t know, but it’s encouraging that the complete response rate did not decrease significantly between 6 months and 1 year. So, we expect some of these patients will remain in complete response for many years. And although it’s unheard of to talk about a cure at this point, I think most of us would not be surprised that some of these patients probably will be cured with CAR T cells, including the axi-cel and others, probably.

So, it’s really new now, the approval, and only specialized centers are allowed to use it because of safety and preparation, expertise. With time, I think this should be available to other centers. But for now, it’s restricted to select centers, including our own center, Memorial Sloan Kettering. And, yes, we’re starting to use it commercially on label. I think as of now, we treated 6 patients and it’s with the clinical trial, and you see responses as have been seen in the clinical trial.

Transcript Edited for Clarity 
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