Repeat CAR-T – pro
The approach of repeating CAR-T therapy is very new and not much information about it had been published. A phase I/II study analyzed data from pts with R/R B-cell malignancies who received a second infusion of CD19 CAR-T cells (CART2) on a phase 1/2 trial (NCT01865617) at our institution. Responses were evaluated 4 weeks after CAR-T cell infusion and defined according to the 2018 NCCN guidelines for acute lymphoblastic leukemia (ALL), 2018 iwCLL for chronic lymphocytic leukemia (CLL), and the Lugano criteria for non-Hodgkin lymphoma (NHL). It revealed Forty-four pts evaluable for response were included in this study (see Table). Pts were heavily pre-treated (median prior therapies, 6), and 16 pts (36%) had bulky (e” 5cm) disease. It observed responses to CART2 in 3 of 14 ALL pts (21%; all CR/CRi), 4 of 11 CLL pts (36%; CR/CRi, n=3; partial response [PR], n=1), and 9 of 19 NHL pts (47%; CR, n=2; PR, n=7). After a 43-month median follow-up, the estimated 4-year PFS and OS probabilities in responders were 23% (95% CI, 9-59%) and 36% (95% CI 19-71%), respectively.
J. Gauthier et al, Repeat Infusions of CD19 CAR-T Cells: Factors Associated with Response, CAR-T Cell In Vivo Expansion, and Progression-Free Survival Biol Bone Marr Transpl VOLUME 26, ISSUE 3, SUPPLEMENT, S267-S268, MARCH 01, 2020
Bezerra, ED, Gauthier J, Hirayama AV, et al. Factors associated with response, CAR-T cell in vivo expansion, and progression-free survival after repeat infusions of CD19 CAR-T cells. Presented at: 61st American Society of Hematology (ASH) Annual Meeting and Exposition. Orlando, FL. December 7-10, 2019. Abstract 201.
Keown, S. Try, try again: Can a 2nd dose of CAR T cells succeed when the first fails? Fred Hutch. Published December 7, 2019. Accessed December 8, 2019.