ASH Annual Meeting 2018 round-up: the latest CAR-T therapy news
This week, the American Society of Hematology (ASH) Annual Meeting saw 30,000 experts gather in San Diego to discuss new research and clinical experience examining blood cancers and other blood disorders. In part one of our round-up, read about the latest breakthroughs in CAR-T therapy – a game changing new treatment for blood cancer.
CAR-T therapies continue to impress
As expected, CAR-T therapy was one of the hot topics at ASH.
The approval of the CAR-T therapy Kymriah in the US was based on the results of the ELIANA trial. The most recent findings were presented by Dr Stephan Grupp from the University of Pennsylvania. It looks like the CAR-T therapy works well in most children and young adults, without the need of additional treatments a year and a half on. Results from another trial called JULIET were also discussed, which wanted to find out if Kymriah worked for adults with diffuse large B cell lymphoma (DLBCL) which wasn’t responding to current treatments. Dr Stephen Schuster from the University of Pennsylvania presented results that show a year and half on the results are still promising, with long lasting remission seen in some people.
But research doesn’t stop here. Although CAR-T therapies can work well, for some people they don’t. Researchers want to understand why this and figure out ways to fix this.
Is two better than one?
Two studies were presented which look at combining CAR-T therapies with other drugs to see if they can boost the treatment response, and make it last longer.
The first was a small study, presented by Jordan Gauthier from the Fred Hutchinson Cancer Research Center in the US, which combined a targeted drug called ibrutinib with CAR-T in people with chronic lymphocytic leukemia (CLL) who were not responding to current treatments. By adding ibrutinib, the killing power of the CAR-T cells was increased, and there was a decrease in cytokine release syndrome – a common but potentially life threatening side effect of CAR-T therapy.
Another small study was presented by Dr Amanda Li from The British Columbia Children's Hospital. This study gave participants CAR-T therapy with a ‘checkpoint inhibitor’, which blocks proteins that allows cancer cells to hide from the immune system. Children in this study had leukaemia, and had not responded to multiple treatments, including CAR-T therapy. Results showed encouraging responses. Adding the checkpoint inhibitor increased the activity of the CAR-T therapy and overcame treatment resistance in some children.
New CAR-T therapies on the horizon
Competition is fierce in the development of the next CAR-T therapy in myeloma, and the results from lots of trials were presented at ASH. All had differing results. It looks like we could see a new CAR-T therapy approved by the FDA in the US next year.
Contenders against CAR-T therapies
A variety of other treatment approaches are currently underway, which include "off the shelf" CAR-T therapies, which don’t need to be personalised for each person. Bispecific T cell engagers (BiTEs) are also showing promise. These drugs are based on a type of immune protein called an antibody that helps the immune system fight cancer.
As each approach continues to advance, adverse events and costs may become a deciding factor.
Read part two of our round-up of ASH 2018