Hematologic Oncology Update, Issue 3, 2016 (Video Program) - Video 28Emerging research with CAR-T therapy in MM
2:01 minutes.
TRANSCRIPTION:
DR LONIAL: I think that in my view, the real issue with CAR T cells is, is there a better target than CD19? And I think that there are a couple of candidates. CD38 obviously is one that people are interested in. The one to me that’s the best is BCMA. And the NIH group has tested a CAR T cell against BCMA. The response rate looked pretty good. We don’t know about response duration. The cytokine release syndrome continues to be an issue amongst patients receiving the highest dose of therapy. And I guess in my view, CAR T cells are important. They’re clearly effective. And they will be a way that we treat many diseases down the road. We are also beginning to develop BiTEs in myeloma, the bispecific antibodies, so CD3 partnered with BCMA or CD3 partnered with CD38. These, I think, will offer similar efficacy to what we see with the CAR T cells. And the advantage of the BiTE, in my view, will be that it’s an off-the-shelf preparation. You don’t have to go through all this process of making a cell, finding problems with the manufacturing process. With the BiTE, you pull it off the shelf and you give it. DR LOVE: And I guess the only agent I’m aware of right now that has that technology is blinatumomab, mainly in ALL. Is that the only one we have right now? DR LONIAL: There are Phase Is now in myeloma looking at CD38 and BCMA as BiTEs separate from blinatumomab. DR LOVE: You mentioned off the shelf. And I’m hearing things about off-the-shelf CAR T cells. DR LONIAL: Mm-hmm. DR LOVE: Do you know anything about that? DR LONIAL: Yes. I mean, I think it’s very early days with that. Allogeneic CAR T cells are being proposed where there’s an off-the-shelf mechanism. I think that in some ways, that may lose the potential advantage of a CAR T cell, which is that if you’re going to be successful in the long term, you want those cells to hang around for a long time to give you immunosurveillance. If it’s an allo cell, it may not have that ability to do that. |