Dr Stephen Schuster Outlines CAR T Results Seen in Leukemia, Lymphoma, and Myeloma

Stephen Schuster, MD, of the Perelman School of Medicine, provides a summary of results seen with CAR T treatments in leukemia, lymphoma, and myeloma.

What have been the promising results seen in CAR T treatments for patients with leukemia, lymphoma, and myeloma?
Lots of promising results in leukemia and lymphoma. The myeloma results are early, but the leukemia and lymphoma results have already translated into 2 commercially available products. The leukemia, specifically, is B-cell acute lymphoblastic leukemia (ALL), the leukemia that's most common in children. And the target of therapy is CD19, so this is CARs directed against CD19, which is on the surface of B-call ALL. And there, there's an 80% response rate and at 1 year, 75% of the kids are in good shape, in remission. And these are kids with acute lymphoblastic leukemia, who have disease that is either recurred after standard therapy or doesn't respond to standard therapy, or that have had transplants and have recurrence after transplants. So it offers a potentially long-term, durable remission for these kids.

The lymphoma indication, so far, is diffuse large B-cell lymphoma, and there we have roughly 40% remission rates, regardless of which study you're talking about and which CAR T cell you're talking about, and they're durable. So, I have some of the longest follow-up, which I pulished yesterday in the New England Journal of Medicine, and these patients in remission, it lasts for years. The median follow-up in that report was 29 months, and none of the respondents had relapsed. So, this is a breakthrough for relapsed/refractory lymphoma patients who don't respond to conventional therapies or to salvage therapies.

With regard to myeloma, they're at about where lymphoma was 3 years ago. They need more trials with larger numbers of patients and longer follow-up, bubt preliminarily, the target, BCMA on the malignant plasma cells of myeloma, looks very susceptible to the CAR T approach. Lots of things about CAR T at this meeting; it's clear to me that CAR T cells are a paradigm and we can make CAR T cells to any specific tumor antigens or viral antigens, for that matter, and have a T-cell therapeutic approach.
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