Hematologic Oncology Update, Issue 3, 2016 (Video Program) - Video 8Administration of most closely HLA-matched multivirus-specific (“off the shelf”) T-cell therapy
2:17 minutes.
TRANSCRIPTION:
DR NASTOUPIL: The manufacturing has been a challenge, particularly for the highly aggressive lymphomas. So a lot of the manufacturing’s happening at central sites. And again, we’re at the mercy of when those cells are available, which can be anywhere from 2 to 5 weeks. So off the shelf is where essentially you identify an antigen where you have a T cell sitting on a shelf, meaning someone else’s T cell, that will bind and effectively eliminate that antigen. The Baylor folks across the street from us in Houston have probably done most of that work, where they’ve been very successful. So there was an ASH presentation from Dr Helen Heslop and her group, looking at essentially off-the-shelf CAR Ts with very high response rates. I think that’s probably much more feasible, if we start expanding this more broad stroke to more patients. But I also think that the toxicity still needs to be taken into consideration. And the efficacy in terms of duration of response is still an unanswered question. But that appears quite appealing. DR LOVE: So and obviously there are a number of cancers where we’ve heard success stories, including ALL. I’m not exactly sure what the FDA approval status is on any of these approaches. Is it likely or possible that one of these therapies is going to be approved in the near future, and in what disease? DR NASTOUPIL: So I think that’s a great question. I think the acute leukemias are much further along than the lymphomas are, but we are accumulating quite a bit of data with diffuse large B-cell lymphoma. And we’ve completed a study that we expect will be before the FDA in the spring of 2017. None of these are currently FDA approved, but we are looking at the toxicity very, very closely. There are a number of pharmaceutical companies that are pursuing this outside of institution-developed CAR Ts. And there are plenty of centers across the United States that are developing their own version of CAR T, including MD Anderson. So I think that these things are clearly in the pipeline. I don’t think any of them will be FDA approved in the near future, at least not for lymphoma. But I don’t think it’s too far off, either. And really identifying the toxicity and management is where most of the interest is right now. DR LOVE: Although I have to say, I mean, when you’re talking about, like, this case, primary refractory diffuse large B-cell has already gotten a couple — several therapies. And then you hear stories like this. You kind of wonder why it isn’t available, like, now. DR NASTOUPIL: I completely agree. And so I have a handful of patients that I know they would be dead now if they did not have access to this therapy. And so I do think that this is something that will continue to be investigated. It will continue to evolve. And if we can dial down the toxicity while maintaining the efficacy, this is really exciting. |