Jordan Gauthier, MD, MSc, senior clinical research fellow, Fred Hutchinson Cancer Research Center, discusses the potential for chimeric antigen receptor (CAR) T-cell therapy in the treatment of patients with chronic lymphocytic leukemia (CLL).
At the 2018 ASH Annual Meeting, Gauthier presented a study comparing the efficacy and toxicity of the CD19-directed CAR T-cell therapy JCAR014 alone and in combination with the BTK inhibitor ibrutinib (Imbruvica). CAR T cells have demonstrated promise in acute lymphoblastic leukemia and non–Hodgkin lymphoma, Gauthier says, but this type of treatment has not made much headway in CLL. However, recent data have suggested that patients who have relapsed on ibrutinib can achieve deep and durable responses with JCAR014.
Preclinical data suggested that this CAR T cell product in combination with ibrutinib can be beneficial. Gauthier says this could be due to the fact that treatment with ibrutinib in these patients is usually discontinued before CAR T-cell therapy, resulting in a “tumor flare.” Continuing ibrutinib into the infusion of JCAR014 could help overcome this.