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CAR-T Meeting 2021 | An overview of the CAR T-cell therapy story

Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, gives an overview of the CAR T-cell therapy story so far. The introduction of CAR T-cell therapy was a real revolution in the field of hematology. Following the breakthrough clinical results in the pivotal trials, the United States Food and Drug Administration (US FDA) and the European Medicines Agency (EMA) have approved two anti-CD19 CAR T-cell products: tisagenlecleucel for the use in children and young adults up to 25 years of age with relapsed/refractory (R/R) acute lymphoblastic leukemia, and tisagenlecleucel and axicabtagene ciloleucel for the use in adult patients with R/R diffuse large B-cell lymphoma. In addition, several clinical trials are currently investigating the use of CAR T-cells in other hematological malignancies. It is anticipated that other CAR T-cell products will soon be approved. This interview took place during the 3rd European CAR T-cell Meeting.

Transcript (edited for clarity)

The CAR T-cell introduction is really a true revolution in the field of hematology and cancer in general. Actually, it’s a relatively old story because the initial publications are from more than 30 years ago or so. But developing a new drug sometimes takes a lot of time. You need to refine a step-by-step the construct, the product, the manufacturing process.

We were fortunate enough, in 2017 and 2018, after, of course, different clinical trials, to have the first CAR T-cell commercial product being approved in non-Hodgkin lymphoma and in acute lymphoblastic leukemia in young patients...

The CAR T-cell introduction is really a true revolution in the field of hematology and cancer in general. Actually, it’s a relatively old story because the initial publications are from more than 30 years ago or so. But developing a new drug sometimes takes a lot of time. You need to refine a step-by-step the construct, the product, the manufacturing process.

We were fortunate enough, in 2017 and 2018, after, of course, different clinical trials, to have the first CAR T-cell commercial product being approved in non-Hodgkin lymphoma and in acute lymphoblastic leukemia in young patients. That represented, in my opinion, a turning point in the field of cellular therapy because we’re talking here about a very sophisticated mechanism of action, highly effective. Because even in relapsed refractory lymphomas and ALLs, one can achieve 30 to 40% long-term remission and likely cure in many patients.

Obviously, we spoke a lot about the side effects, the toxicities, the complex logistics, but it’s more about a learning curve, in my opinion. When I look into the last five years, actually, we could clearly see that the management in the handling of side effects, like cytokine release syndrome, neurotoxicity, infectious complications, has dramatically improved. Actually, the results keeps on improving. This is really very good news. Actually, it’s paving the way for further developments because, beside ALL, beside the lymphoma, now we do have other candidates: acute myeloid leukemia, there are clinical trials, Hodgkin lymphoma, and, last but not least, we hope to see, soon, some new CAR T-cell products in multiple myeloma. Clearly, the last five years, thanks to the introduction in routine practice of CAR T-cells, represented truly a revolution in the hematology field. It’s really a very, very exciting era for all of us.

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