[ Anglais] Who Will Benefit From CAR T-Cell Therapy?

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Topics include: Treatments and Understanding

Genetically modifying a patient’s own T cells to attack their cancer cells through the innovative CAR T-cell therapy has shown promising results in clinical trials. Could CAR T-cell therapy be the right option for your chronic lymphocytic leukemia (CLL)? How can patients tell if this exciting type of immunotherapy is a good match? Our panel of experts, including Dr. Alessandra Ferrajoli and Dr. Michael Keating, discuss what conditions are suited for CAR T-cell therapy, the duration of the results, and what the procedure for CAR T-cell therapy entails. The panel also shares when CAR T-cell therapy should be considered. Watch now to find out more.

Provided by CLL Global Research Foundation, which received support from AbbVie Inc., Gilead Sciences, Inc., Pharmacyclics LLC and TG Therapeutics. It is produced by Patient Power in collaboration with The University of Texas MD Anderson Cancer Center.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jeff Folloder:

One of the things that’s in the news a lot, lately, is this thing called CAR-T cell. Now, I’m gonna try to stumble through chimeric antigen receptor? Okay, I got that right. 

Dr. Ferrajoli, what is going on with CAR-T cell—what does that treatment entail? 

Dr. Ferrajoli:    

So, the CAR-T cell are basically your T cells, that have failed to recognize the CLL cells, and kill them, in the past, that go through a process of, if you wanna call it, education. Where they get inserted, a chimeric antigen receptor, that will bind some of the molecules that are expressed on the CLL cells. So, it’s a way to reeducate your body, and tell your body that those cells are supposed to go and kill your CLL cells. So, it’s—the cells are taken from you, they go through a laboratory process, that takes several weeks, where they’re modified again, to become targeting different types of receptors, with different types of component inserted.  

And then, you will receive a mild type of chemotherapy, that is used to make room for those cells, to suppress your own immune system, to make room for the cells to go and attack the CLLs. And then, they’re infused, and you will be monitored before they are activated.

Jeff Folloder:   

Does it work for everybody? 

Dr. Ferrajoli:    

It doesn’t work for everybody, it works roughly for about half of the people. The duration of the benefit is also variable. But, it’s really a very interesting strategy, doesn’t have to be the only strategy that you can receive, it could be used as a bridge for future therapy, it could be used as a way to reinforce a response, that you already have. The important thing to understand is that I see it as a treatment that is still in its infancy, where we are all learning how to best use it. 

So, I see it as a treatment that, in the future, will be further positioned in a context where it can be more—best useful.  

Jeff Folloder:   

Dr. Keating, do we know who’s more likely to benefit from this treatment, or is it just a crapshoot? 

Dr. Keating:     

No, it’s whoever is looked after by Dr. Lamanna or Dr. Ferrajoli, or me, and then Jackie goes into a dark room, and picks out a number, and says, that’s the guy. No, we don’t. We do know that there are more complications of the process that occur, in older people. And, the first report was a very dramatic report, from the University of Pennsylvania, U Penn, with Dr. Carl June. And, there were three patients that had magic responses. And, everyone thought that that was it. 

And, but then, there’s an area—we haven’t had very much luck with acute lymphocytic leukemia, with transplant. But, strangely, with these chimeric antigen receptors, or the CAR-T cells, the kids with, and young adults with ALL, they’re the ones that have the least toxicity, and the greatest likelihood of being cured. And, it is a potentially curative treatment, so that as was already said, it really is in its infancy, in fact, one of the thoughts that are appearing is that ibrutinib (Imbruvica), which is one of these targeted therapies, it appears that if you continue that, while they’re getting the CARs, it makes the whole thing work better, and with less toxicity, and that was unexpected, it was not part of the framework that we are looking at.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on May 17, 2018