Terry J. Fry, MD
While clinical trial findings with chimeric antigen receptor (CAR) T-cell therapy have impacted the landscape of pediatric acute lymphoblastic leukemia (ALL), most notably with the 2017 FDA approval of tisagenlecleucel (Kymriah), additional CAR T-cell products continue to be investigated.
There are several clinical efforts currently aiming to improve CD22- and CD19-directed CAR T-cell therapy remission durability. Poor T-cell expansion can contribute to a lack of CAR persistence, leading to the failure of the treatment, Fry said. Ways to combat this are the addition of checkpoint inhibitors and vaccines, which are both being investigated. For leukemia resistance, Fry suggested multispecific targeting, target antigen modulation, and alternative targets.
Maude SL, Laetsch TW, Jochen Buechner J, et al. Tisagenlecleucel in children and young adults with b-cell lymphoblastic leukemia. N Engl J Med. 2018; 378:439-448. doi: 10.1056/NEJMoa1709866.
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