Dr Kitko on the Utility of Obe-Cel in Pediatric Patients With B-ALL

Carrie L. Kitko, MD, discusses the use of obecabtagene autoleucel for pediatric patients with relapsed/refractory B-cell acute lymphoblastic leukemia.

Carrie L. Kitko, MD, associate professor of pediatrics, Hematology/Oncology, Ingram Professorship in Pediatric Oncology, Department of Pediatrics, medical director, Pediatric Stem Cell Transplantation Program, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, discusses the investigation of obecabtagene autoleucel (obe-cel) for pediatric patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL).

Kitko states that she is optimistic about increasing pharmaceutical interest in pediatric oncology treatments, and recent developments in this space. One such advancement is a product called obe-cel, which was developed in the Europe and is now entering global trials, she explains. This product features a slightly different CAR construct than other CD19-targeted CAR T products, binding to CD19 to drive anti-leukemia activity but displaying a lower binding affinity. This lower affinity results in fast on-off kinetics, which is believed to lead to increased T cell persistence and reduced exhaustion, Kitko explains. Moreover, this characteristic may enhance the product's safety profile, she notes.

Several trials have been conducted to evaluate obe-cel's efficacy and safety, Kitko expands, adding that a pediatric-specific trial has shown promising results. The agent was also evaluated in 2 larger studies primarily focused on adults, although some adolescent and young adult patients with either ALL or B-cell lymphomas were included. One of these trials was the phase 1b/2 FELIX study (NCT04404660), which demonstrated an overall response rate of 77% with obe-cel in patients with relapsed or refractory B-ALL, Kitko reports. This study also reported a 12-month event-free survival rate of 50%, she emphasizes.

A particularly notable finding from these trials is the low incidence of severe adverse effects. The rate of grade 3 cytokine release syndrome was less than 5%, and instances of neurologic toxicity were rare, Kitko continues. These results suggest that obe-cel could be a safer option compared with existing treatments.

Given these outcomes, Kitko is hopeful that obe-cel could be further developed and expanded into pediatric use in the United States. The potential for obe-cel to provide a safe and effective treatment for pediatric patients is exciting, Kitko says, concluding that she looks forward to the possibility of integrating this innovative therapy into broader clinical practice.

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