Jordan Gauthier, MD, MSc
Retrospective data have demonstrated that concurrent treatment with ibrutinib (Imbruvica) and the chimeric antigen receptor (CAR) T-cell product JCAR014 elicits high responses and lower rates of severe toxicity in patients with relapsed/refractory chronic lymphocytic leukemia (CLL). However, prospective trials need to be conducted to confirm these findings, explained Jordan Gauthier, MD, MSc.
, Gauthier, a senior clinical research fellow at Fred Hutchinson Cancer Research Center, discussed these results and where CAR T-cell research is headed for patients with CLL.
OncLive: Could you provide some background on this phase I/II trial?
: We’ve seen some very impressive results with CAR T cells in ALL and NHL, particularly with aggressive lymphoma. The results in CLL [are] not as good. We have, nonetheless, demonstrated that by using a CD19-specific CAR T-cell product, JCAR014, we could achieve some durable responses in patients refractory or having relapsed after ibrutinib. We tried to go a little further, and there is actually a body of data, preclinical and clinical data, that suggest ibrutinib and CAR T cells could be beneficial. Why is that? It could be beneficial because sometimes you stop ibrutinib just before the infusion of CAR T cells or before full depletion. If patients have what is called tumor flare, the lymph nodes get much bigger, and there’s rapid tumor progression. By continuing ibrutinib, it might be beneficial.
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