Stanford study offers hope to CAR T-cell therapy relapsed B cell lymphoma patients
CANCER DIGEST – July 20, 2024 – In a small study, half of the patients whose lymphoma failed to respond to all previous treatments including CAR T-cell therapy, responded to a new CAR T-cell therapy, with half surviving another two years.
Outcomes for patients with CART therapy relapsed B cell lymphoma are poor, with most surviving six months or less.
The small dose-finding clinical trial led by Frank Matthew, MD, PhD of Stanford University Medicine involved 38 patients with large B-cell lymphoma whose cancer failed to improve with chemotherapy. Of these, 37 had also failed to respond to CAR-T therapy. The results appeared online first ahead of the July 9, 2020 The Lancet.
CAR-T therapy involves removing immune system cells that already target the cancer, inserting a gene that helps the T-cells to zero in on cancer cells with a protein, called CD-19, and growing millions more of those cells and re-infusing them back into the patient.
About 80 percent to 90 percent of patients that undergo this CD19-targeted CAR T-cell therapy achieve remission, but about half of those relapse within 12 months, according to researchers at the University of Colorado Cancer Center.
“On average, the patients enrolled in this trial had received four previous lines of therapy,” Dr. Frank said in a press release.“These patients are out of likely curative options, and they are scared. Half of them will die within five to six months. But in this trial, we saw a very high rate of durable complete responses, meaning their cancers became undetectable.”
In this new Stanford trial Dr. Frank and colleagues used CAR T-cells that target a different protein, CD22. The results showed that half of the 38 patients experienced a complete response, and are surviving at least two years after treatment.
The researchers emphasize that this was a phase 1 dose-finding clinical trial that will need to be followed up with larger clinical trials involving more patients to define the outcomes of CD22 CAR-T therapy.
In the meantime the FDA has designated CD22-targeting CAR-T therapy a Breakthrough Therapy for large B-cell lymphoma. That designation is intended to speed development and review of this therapy.
Dr. Frank and his team are currently launching a larger, phase 2 clinical trial that will involve multiple sites around the country. More information is available at ClinicalTrials.gov ID trial number NCT04088890
Sources: Stanford Medicine press release, University of Colorado press release, The Lancet, Clinical Trials.gov
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