CAR T-Cell Therapy’s Role in AML Treatment

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Topics include: Treatment and Treatment | General

Can AML patients benefit from CAR T-cell therapy? Which patients are a good candidate for this type of treatment? Our panel of AML experts from the American Society of Hematology (ASH) 2017 annual conference, including Dr. Gwen Nichols from The Leukemia & Lymphoma Society (LLS), and Dr. Ross Levine from Memorial Sloan Kettering Cancer Center, discuss the latest research on CAR T-cell therapy for AML. Dr. Levine also shares another recently approved AML treatment announced at ASH 2017. Watch now to find out more. 

This is a Patient Empowerment Network program produced by Patient Power, in partnership with The Leukemia & Lymphoma Society (LLS). We thank Astellas, Celgene Corporation, Novartis, Pfizer and Seattle Genetics for their support.

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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. 

Andrew Schorr:          

I want to go on to something else with you, Gwen. So, your immune system is trained to look for aberrant cells. And many of, like he said, there are leukemia cells in a lot of people who never develop leukemia.

So, there has been a lot of buzz at this medical meeting about an approach that many people may have heard about on the news or in the paper called CAR T-cell therapy, chimeric antigen receptor T cell therapy to take T cells, which are part of your immune system, boost them up, give them a target, and say, like a blood hound, go after that cell that’s aberrant, if I got it right, Ross. I hope I did.

Dr. Nichols:

Mm-hmm. 

Andrew Schorr:          

Okay. So, does that have any place with AML? Because people have heard about it in ALL and in different areas and some lymphomas, this sort of Star Trekian approach almost.

Dr. Nichols:                

So, this is gene therapy, which is really very exciting. And it’s also immune therapy. And we’ve been waiting a long time for immune therapy to hold the promise we have all known it could have, but it just needed that extra boost.

And we’re really seeing an escalation of immune therapies now. CAR T, however, has been designed with antigens, at least at the current time, that are primarily targeting lymphoid cells. So, not the primary cells that are abnormal in acute myeloid leukemia. But there are a lot of experiments looking at different antigens that will be able to be used against myeloid cells. It’s just a little further behind only because antibody therapy, for the lymphoid malignancies, has been around for 20 years. And so, that was the first place, and we knew the antigens the best. So, I think that explains why it’s lymphoid, leukemia, and lymphomas that are the initial targets. But lots coming. And it’s very exciting. 

Andrew Schorr:          

Ross, what do you think? Are you looking for a top myeloid target where you can take a virus and T cells and go after it?

Dr. Levine:                  

A couple of things, I’d say. The first thing I’d say is that I, and anybody else who both does science and takes care of leukemia patients, would never think that one solution is going to be the answer to everything. I think that I’ve had the opportunity to take care of many patients who get CAR T cells for ALL. And the good news is that they’re incredibly efficacious for people that fail chemotherapy. But chemotherapy, and even targeted therapy, work there, too. And I think the exciting thing, for all of us, is it’s another option to add to a sort of armamentarium against the disease.    

And so, we’re really excited about that. I think the other really important thing to recognize is that, even within this idea of the immune system, or even targeting the surface antigen that Gwen mentioned, CAR T cells are just one approach. They’re the most Star Trekian, as you said, because they really are training a living cell to go after it. 

But we have everything from antibodies, which have been around a long time but have gotten a lot better, to something called BiTE specific or BiTE engagers, where you have an antibody that’s got a warhead. And that it brings a T cell. So, instead of the antibody killing, it, actually, says, instead of putting it inside of the T cell, it, actually, goes on and signals to the T cell. And we even have things where you can deploy warheads. Gemtuzumab (Mylotarg) is an example where you have an antibody that goes to a leukemia cell. This is approved for AML this year. And it deposits a poison there. 

So instead of the poison going everywhere in your body, it goes right to the leukemia cell.

Andrew Schorr:          

And you can give a higher dose.

Dr. Levine:                  

That’s right. So I think the great news here is that we have many approaches. And, for me, the lesson for us is that the cell surface, the things that are on the outside of the leukemia cell, are just beginning to be explored. And we’ll see many approaches with all of these different old school to Star Trek and everything in between. And we’re going to see lots more success in all of blood cancers, including AML. 

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 April 12, 2018