Cardiology

Dermatology

Endocrinology

Hematology

Lysosomal Disorders 

Neurology

Oncology 

Ophthalmology

Home

News

Media

All Videos

Clinical Trials in Progress

ImmunoLogic

News Network

Partners

CME/CE

Conferences

Subscribe

About Us

Editorial

Contact Us

Terms and Conditions

Do Not Sell My Information

Privacy

CGTLive®

Facebook

LinkedIn

Topics

Lysosomal Disorders

Oncology

1rem

Topic

Karen M. Winkfield, MD, PhD; Narjust Florez, MD, FASCO; Gilberto de Lima Lopes Junior, MD, MBA, FASCO; Coral Olazagasti, MD; Vonetta M. Williams, MD, PhD

 Fighting Disparities and Saving Lives: An Exploration of Challenges and Solutions in Cancer Care

Craig Emmitt Cole, MD; Sikander Ailawadhi, MD; Irene Ghobrial, MD; Monique Hartley-Brown, MD, MMSc

Addressing Racial Disparities in Multiple Myeloma: Forging a Path Towards Health Equity in Clinical Trials and Everyday Practice

 Neurology specialty topic page houses video interviews with key opinion leaders in the field of neurology about the latest relevant FDA actions, clinical guideline updates, and clinical trial findings related to cell therapies, gene therapies, and engineered and regenerative medicines developed for neurologic disorders and diseases. It also contains up-to-date clinical news coverage in the field of gene and cell therapy for central nervous system disorders.

In Episode 2 of ImmunoLogic, Bruce Levine, PhD, discussed the current the risk-benefit-ratio for CAR-T therapy.

ImmunoLogic, Episode 2: "Charting New Frontiers in CAR T-Cell Safety" With Bruce Levine, PhD

We're excited to introduce another episode of the 

an assistant professor of microbiology and the director of the Fraietta Lab at the University of Pennsylvania! Fraietta is joined by cohost 

, a clinical fellow in oncology (MSTR Program) at the University of Pennsylvania. Our hope is that this show will serve as a critical forum for clinicians, translational researchers, and biotech professionals to explore the evolving landscape of immunotherapy. We're seeking to bridge cutting-edge research with practical applications and delve into how immune-based therapies transition from innovative discoveries to transformative patient care solutions

 the Barbara and Edward Netter Professor in Cancer Gene Therapy at the Perelman School of Medicine at the University of Pennsylvania, about the black box warnings for secondary malignancies that were issued by the FDA with regard to the autologous chimeric antigen receptor T-cell (CAR-T) therapies approved by the agency, and the implications of the findings that informed these warnings for the risk-benefit ratio of these therapies. Levine, Fraietta, and Minehart covered topics including risk and informed consent, genetic modification as it relates to safety, epitope spreading and T-cell stimulation, and the importance of the National Institutes of Health (NIH) to CAR T-cell research.

 is tailored for an audience fluent in the language of medicine and biotechnology, offering data-driven insights while maintaining accessibility. This podcast is an essential resource for those driving the future of immunotherapy.

Interested in co-hosting an episode or being a guest? Have feedback to share? 

If you'd like to get in touch to talk about the show, contact our editorial director, Matt Hoffman: 

Podcasts

In Episode 1 of ImmunoLogic, Stephen J. Schuster, MD, discussed the potential of treating lymphoma without chemotherapy.

ImmunoLogic, Episode 1: "Chemo-Free Lymphoma? Seriously?" With Stephen J. Schuster, MD

, a clinical fellow in oncology (MSTR Program) at the University of Pennsylvania. Our hope is that this show will become a critical forum for clinicians, translational researchers, and biotech professionals to explore the evolving landscape of immunotherapy. We're seeking to bridge cutting-edge research with practical applications and delve into how immune-based therapies transition from innovative discoveries to transformative patient care solutions

, the director of the Lymphoma Program at Penn Medicine, about the changing role of chemotherapy in lymphoma treatment, and the potential for its elimination. Schuster covered topics including trials for chimeric antigen receptor T-cell (CAR-T) therapy without lymphodepletion, using AI to predict CAR-T treatment outcomes, the importance of T-cell fitness, and the role of persistence in CAR-T success.

Joseph Fraietta, PhD, previews his new podcast, ImmunoLogic

ImmunoLogic Episode 0

an assistant professor of microbiology and the director of the Fraietta Lab at the University of Pennsylvania! Our hope is that this show will become a critical forum for clinicians, translational researchers, and biotech professionals to explore the evolving landscape of immunotherapy. We're seeking to bridge cutting-edge research with practical applications and delve into how immune-based therapies transition from innovative discoveries to transformative patient care solutions.

In this short preview episode, Fraietta outlines the podcast’s mission to scrutinize the critical milestones shaping immunotherapy today and discuss how episodes will analyze the journey from bench to bedside—focusing on the real-world implementation of clinical data and the impact of regulatory achievements on patient outcomes. Topics will include discussions on chimeric antigen receptor (CAR) T-cell therapies, tumor-infiltrating lymphocyte (TIL)-based approaches, antibody-driven treatments, and the latest advances in gene editing technologies such as CRISPR, with a goal of expanding the conversation outside of the field of oncology.

 will be tailored for an audience fluent in the language of medicine and biotechnology, offering data-driven insights while maintaining accessibility. With its first full episode launching in early 2025, this podcast promises to be an essential resource for those driving the future of immunotherapy.

Hosted by Joseph Fraietta, PhD, ImmunoLogic will be tailored for an audience fluent in the language of medicine and biotechnology, offering data-driven insights while maintaining accessibility.

CGTLive® Presents: ImmunoLogic, A Video Podcast With Joseph Fraietta, PhD

This interview originally appeared on our sister site,

to subscribe on your favorite streaming service.

The Mind Moments podcast features exclusive interviews with leaders in neurology discussing the latest research and disease management strategies across the breadth of the field, including epilepsy, multiple sclerosis, Parkinson disease, dementia, sleep disorders, and more.

In this episode, "The Promise Behind Cell Therapy Approaches in Epilepsy" Jonathan Parker, MD, PhD, an assistant professor of neurosurgery at Mayo Clinic Arizona, speaks on the emerging interest in cell therapy as a potential means to address epilepsy. The discussion, which took place at the 2024 American Epilepsy Society (AES) Annual Meeting in Los Angeles, California, goes into the rationale behind this approach and the advantages it may have over traditional surgical approaches that can result in detrimental cognitive effects. Parker, director of the Device-Based Neuroelectronics Lab, went over the different types of cell therapies currently in development, limitations and challenges associated with these approaches, and the need to design innovative clinical studies to test them appropriately. In addition, Parker touched on the therapeutic pipeline of cell therapies for epilepsy, including his experience leading a study site for a first-in-human trial evaluating NRTX-1001, an investigational product derived from human pluripotent stem cells.

The stories featured in this week's Neurology News Minute, which provide quick updates on the following developments in neurology, are further detailed here:

Anavex Submits Marketing Authorization Application for Blarcamesine in Alzheimer Disease in the EU

Testing Begins for RELIEV-CM2 Study of ShiraTronics Neuromodulation Device in Chronic Migraine

STK-001 Gains FDA Breakthrough Designation as Potential Disease-Modifying Treatment for Dravet Syndrome

 – Idea behind cell therapy to treat epilepsy

 – Current state of stem cell therapies for neurological disorders, focusing on Parkinson disease, stroke, and epilepsy

 – NTE001 study for NRTX-1001, an investigational human embryonic stem cell product

 – Unanswered questions and safety concerns with cell therapies; challenges with clinical trial design and the need for more innovative trials

 – Misconceptions or gaps in understanding about cell therapies for epilepsy

 – Unique challenges and potential of stem cell therapies for epilepsy, particularly in younger patients; patient motivation and hope

 to subscribe to the Mind Moments podcast, and be sure to leave a rating and review for the show. Thanks for listening!

Hoping to listen on your favorite podcast app? See below:

Mind Moments®, a podcast from our sister site NeurologyLive®, held an exclusive interview with Jonathan Parker, MD, PhD.

The Promise of Cell Therapy Approaches in Epilepsy

Donovan Decker, recipient of the 2025 MDA Legacy Award for Community Impact and Research, discussed his powerful journey as a patient advocate and gene therapy pioneer, shedding light on challenges and progress in LGMD.


Donovan Decker’s Journey in Gene Therapy and Advocacy for LGMD—Breaking Barriers

Michael Flanagan, PhD, the chief scientific officer at Avidity, discussed the function and mechanism of the investigational antisense treatment, which is in development for DMD amenable to exon 44 skipping.


Del-Zota for Duchenne Muscular Dystrophy

Review top news and interview highlights from the week ending March 21, 2025.

CGTLive®’s Weekly Rewind – March 21, 2025

In observance of Multiple Sclerosis Awareness Month, held annually in March, we took a look back at the past year's news in cell therapy for MS.

Multiple Sclerosis Awareness Month 2025: Looking Back at Progress for Cell Therapy

One of the patients, who was aged 3 years at the time of treatment, achieved 122.3% microdystrophin expression compared to control.

REGENXBIO’s DMD Gene Therapy RGX-202 Generates Microdystrophin Expression in Additional Patients Treated in Phase 1/2 Trial

This is the second part of an interview with Barry J Byrne, MD, PhD. For the first part,

The chief medical advisor of the Muscular Dystrophy Association also shared his thoughts on the 75th anniversary of the organization.

Barry J Byrne, MD, PhD, on MDA Care Centers and the Future of Gene Therapy in Neuromuscular Disease

“One of our own efforts [for the future] is to ensure that a level of expression can be sustained over the lifespan, meaning the potential for redosing AAV vectors. This would be relevant to individuals who either received first generation products or may receive a treatment at a very early age.”

 recently spoke with Barry J Byrne, MD, PhD, the chief medical advisor of Muscular Dystrophy Association (MDA) and a physician-scientist at the University of Florida, 

 at the upcoming 2025 MDA Clinical & Scientific Conference, which will be held from March 16 to 19, in Dallas, Texas. As part of the discussion, 

 asked Byrne about the MDA Care Centers, which the organization has established throughout the United States, and the future of the field of gene therapy for neuromuscular disease in general.

Byrne discussed the role and impact of MDA Care Centers, emphasizing their multidisciplinary approach to patient care. With over 150 sites across the US, these centers provide comprehensive support for people with neuromuscular diseases, including amyotrophic lateral sclerosis (ALS). The model ensures coordinated care, access to essential resources like durable equipment and testing, and availability of emerging therapies. Notably, in 2025, MDA will host a Care Center Directors meeting before the annual conference to share best practices, foster collaboration, and seek to enhance long-term patient outcomes.

With regard to the future of the field, Byrne highlighted recent advancements in gene therapy, particularly in the treatment of Duchenne muscular dystrophy (DMD). Notable progress includes improvements in capsid targeting and adeno-associated virus (AAV) vector manufacturing, which will lower costs and expand treatment accessibility. A major focus in DMD is on developing a larger dystrophin protein that more closely mimics the full-length, functional version found in unaffected individuals. Byrne also discussed MDA’s own efforts to innovate in the gene therapy space.

Byrne concluded by acknowledging the 75th anniversary of MDA. He expressed pride in MDA’s role in improving patient outcomes and contributing to the discovery of new therapies, and expressed hope that the coming years will bring continued progress.

Click here to register for the upcoming 2025 MDA Conference

Videos

The chief medical advisor of the Muscular Dystrophy Association also shared his thoughts on the 75th anniversary of the organization. 

The chief medical advisor of the Muscular Dystrophy Association discussed what attendees can expect at the 2025 MDA Meeting.

Barry J Byrne, MD, PhD, the chief medical advisor of MDA and a physician-scientist at the University of Florida

“Really, this is the era of therapies for neuromuscular diseases. In the past year, we saw an additional few strategies that are transformative in the care of boys with Duchenne muscular dystrophy (DMD) and we have continued to make advances in spinal muscular atrophy (SMA) care following on the enormous success of the release of Zolgensma in 2019.”

The Muscular Dystrophy Association (MDA) is an organization dedicated to serving the community of patients with neuromuscular disorders, both those with muscular dystrophies and those with other types of neuromuscular disease. Each year, the organization holds the MDA Clinical & Scientific Conference to bring together physicians, clinical trial investigators, academic researchers, patient advocates, biotech executives, and other stakeholders to share and discuss the latest findings in neuromuscular disease research. This year’s meeting, which will be held from March 16 to 19, 2025, in Dallas, Texas, is notable for coinciding with the 75th anniversary of the organization itself.

 reached out to Barry J Byrne, MD, PhD, the chief medical advisor of MDA and a physician-scientist at the University of Florida, to learn more about what attendees can expect at this year’s event, which Byrne highlighted that around 1,500 or more people are expected to attend. He emphasized that the field of muscular dystrophy has recently entered the era of disease-modifying treatment after a long history of basic research, thanks in part to the FDA’s approvals of several gene therapy products for neuromuscular diseases in recent years, including nasemnogene abeparvovec (Zolgensma; Novartis) for SMA and delandistrogene moxeparvovec-rokl (Elevidys; Sarepta Therapeutics) for DMD. Furthermore, he noted that means of maximizing muscle regeneration in patients with degenerative neuromuscular diseases, real world experience with Elevidys following its 2024 expanded access approval, and tackling challenges with access to treatment or reimbursement will be among the themes at the 2025 conference.

Barry J Byrne, MD, PhD, on MDA’s Upcoming 2025 Clinical & Scientific Conference

The attending physician at the Cancer Center at Children's Hospital of Philadelphia discussed a study she coauthored that was recently published in Blood.

Caroline Diorio, MD, FRCPC, FAAP, on Noninflammatory Neurotoxicity Events in Patients Receiving CAR-T

“...[CAR T-cells] come with a set of side effects that we don't have the same level of experience that we do with chemotherapy that's been around for 50, 60, or 70 years. I think we need to bring our attention to the toxicities associated with CAR-T with the same rigor that we approach understanding curative therapies.”

In recent years, chimeric antigen receptor T-cell (CAR-T) therapy has provided a transformative new treatment option for patients with hematologic malignancies. In some cases, CAR-T therapy is able to achieve responses in patients who relapsed or were refractory to more traditional cancer treatments, such as chemotherapy. Despite this advantage, CAR-T is not without its own drawbacks, especially when it comes to unique safety concerns. One of the most prominent safety concerns associated with CAR-T therapy is its tendency to produce neurotoxicity, with immune effector cell-associated neurotoxicity syndrome (ICANS) constituting a particular concern of this type. As of yet, research aimed at gaining a better understanding of the pathophysiology of adverse events associated with CAR-T is still ongoing. One such study, “Quadriparesis and paraparesis following chimeric antigen receptor T-cell therapy in children and adolescents” was recently published in 

. The study looked at a small group of children who experienced quadriparesis or paraparesis ICANS phenomena following treatment with CAR-T. Notably, the investigators found that the ICANS was not associated with inflammation, in contrast to expectations.

 reached out to first author Caroline Diorio, MD, FRCPC, FAAP, an attending physician at the Cancer Center at Children's Hospital of Philadelphia, to learn more. Diorio gave some background context regarding the study and went over the key findings. Afterwards, she discussed bigger picture implications of these findings, emphasizing that cases of neurotoxicity following CAR-T need to be considered uniquely based on their phenotypes, as they may have different underlying pathophysiology.

REFERENCE
1. Diorio C, Hernandez-Miyares L, Espinoza DA, et al. Quadriparesis and paraparesis following chimeric antigen receptor T-cell therapy in children and adolescents. Blood. 2024;144(13):1387-1398.

This interview originally appeared on our sister site, 

The three experts discussed Lexeo Therapeutics’ LX1001 gene therapy trial that demonstrated promising safety and biomarker effects in patients with early-stage Alzheimer disease.

R. Nolan Townsend, Sandi See Tai, MD, and Kim G. Johnson, MD, on Gene Therapy for APOE4 Homozygous Alzheimer Disease

"APOE4 homozygotes have no good treatment options right now, and this trial offers a potential treatment that provides hope for patients and their families.”

Risk for Alzheimer disease (AD) is known to be strongly associated with apolipoprotein E (

) polymorphisms. Research demonstrates that people homozygous for 

 have a 14.5-fold higher risk for late-onset AD than those who are homozygous for 

. In addition, those who are heterozygous for 

 are at a 2.6-fold increased risk, thus pointing to a the potential of a protective role for 

. Lexeo Therapeutics' LX1001, an investigational adeno-associated virus vector-based gene therapy, is intended to provide a copy of the 

 gene to the cells of the central nervous system in patients with AD who are homozygous for 

. As such, the approach is expected to convert the genotype of transduced cells to 

 and to in turn slow disease progression.

LX1001 is currently being evaluated in a phase 1/2, open-label, dose-finding clinical trial (NCT03634007). Data from the study presented at the 2024 Clinical Trials on Alzheimer’s Disease (CTAD) conference, held October 29 to November 1, in Madrid, Spain, showed that LX1001 was generally safe and well-tolerated, and demonstrated a dose- and time-dependent effect on expression of 

. Furthermore, a reduction in several cerebrospinal fluid (CSF) AD tau biomarkers and changes on Tau PET suggested a treatment effect of the gene therapy on tau, which researchers note is a critical component in the pathobiology of AD.

At CTAD 2024, R. Nolan Townsend, chief executive officer at Lexeo, coauthor Sandi See Tai, MD, chief development officer at Lexeo, and lead author Kim G. Johnson, MD, the division chief of memory disorders at Duke University, sat down with 

 to speak about some of the key safety findings from the trial. During the conversation, the trio also talked about how the 

 gene delivery impacted amyloid and tau biomarkers in trial participants, as observed in the study findings. Additionally, the experts spoke about the significance of targeting those homozygous for 

 with gene therapy in the AD treatment landscape.

REFERENCES
1. Johnson K, et al. Safety and Preliminary Efficacy of AAV Gene Therapy (LX1001) in Patients with APOE4 Homozygote Alzheimer’s Disease – Interim Data from a Phase 1/2, Open-Label, 52-Week, Multicenter Study. Presented at: 2024 CTAD; October 29-November 1; Madrid, Spain. Abstract 486.
2. Lexeo Therapeutics Announces Positive Interim Data for LX1001, First-Ever Gene Therapy to Impact the Underlying Genetic Cause of APOE4-Associated Alzheimer’s Disease, at the Clinical Trials on Alzheimer’s Disease (CTAD) Conference. News Release. Lexeo Therapeutics. Published October 30, 2024. Accessed October 20, 2024.

The 3 experts discussed Lexeo Therapeutics’ LX1001 gene therapy trial that demonstrated promising safety and biomarker effects in patients with early-stage Alzheimer disease. 

The chief research officer of the Muscular Dystrophy Association discussed the upcoming MDA Clinical and Scientific Conference, which will be held March 16-19, in Dallas, Texas.

Sharon Hesterlee, PhD, on MDA 2025 as a Mixer for Strategies and Collaboration

"Our goal is really about community—bringing together all these different facets, from clinical care to research, to create incredible momentum."

The Muscular Dystrophy Association (MDA) will hold the annual MDA Clinical and Scientific Conference for 2025 from March 16 to 19 in Dallas, Texas. The 4-day event will gather scientific and medical professionals, patients, and advocacy groups to discuss and share the latest advances in the field of neuromuscular disorders. Research pertaining to the range of neuromuscular disorders, from amyotrophic lateral sclerosis (ALS), to Duchenne muscular dystrophy, to spinal muscular atrophy, to limb-girdle muscular dystrophy, to myasthenia gravis, to Charcot-Marie-Tooth disease, and more will be represented at the meeting.

Furthermore, there will be session tracks featured on topics including strategies for regenerating muscle and nerve tissue, new insights into disease mechanisms, clinical experience in gene therapy, access and reimbursement, and clinical trial readouts. Notably, MDA's 2024 Clinical and Scientific Conference was the largest global gathering of the neuromuscular disease community, with 1492 in-person and 567 virtual attendees from over 30 countries. Those who are registered with MDA may partake in the virtual meeting in 2025 at no-cost or may register in-person at the patient/caregiver rate until allotted spots are filled.

In anticipation of the upcoming meeting, 

, reached out to Sharon Hesterlee, PhD, the chief research officer of the Muscular Dystrophy Association, to discuss the primary focus areas of the 2025 conference, particularly in muscle regeneration and ALS research. Hesterlee also spoke about how the conference addresses the challenges of workforce diversity and training in neuromuscular specialties. She also talked about the roles of advocacy groups and allied health professionals in shaping the discussions at the upcoming meeting.

REFERENCE
1. Registration Now Open for the 2025 MDA Clinical & Scientific Conference Featuring the Latest Innovations in Neuromuscular Disease Research and Care with Global Leaders, March 16-19 in Dallas, TX. News Release. MDA. July 30, 2024. Accessed October 24, 2024. https://www.mda.org/press-releases/2024/registration-now-open-for-the-2025-mda-clinical-and-scientific-conference-featuring-the-latest-innovations-in-neuromuscular-disease-research-and-care-with-global-leaders-march-16-19-in-dallas-tx

The vice president of Public Policy & Advocacy of the Muscular Dystrophy Association discussed the growing interest in gene therapy for attendees of the annual meeting.

Paul Melmeyer, MPP, on the Importance of Gene Therapy for MDA’s Upcoming 2025 Conference

“The field is learning at lightspeed pace about gene therapies... It's really quite an amazing time to be a clinician in neuromuscular diseases, learning more about how to administer gene therapies and how these gene therapies that are approved by the FDA actually work for those with neuromuscular conditions.”

Each year, the Muscular Dystrophy Association (MDA), an organization dedicated to serving the community of patients with muscular dystrophies and other neuromuscular disorders, holds the MDA Clinical & Scientific Conference. The event brings together practicing clinicians, medical researchers, and members of patient advocacy groups under one roof to discuss and share ongoing research in the field. Notably, this year, the event will be held on March 16-19, 2025, in Dallas, Texas.

In early anticipation of the upcoming conference, 

 has gotten in touch with Paul Melmeyer, MPP, the executive vice president of public policy & advocacy at MDA, to learn more about the growing importance of the annual meeting to the field of gene therapy and the significance of the conference for the aforementioned interested groups. Melmeyer emphasized the importance of the conference for advocacy groups, around 40 to 50 of which are likely have a presence at the conference. Furthermore, he noted that members of these advocacy groups would convene for a meeting referred to as the Neuromuscular Advocacy Collaborative focused on public policymaking goals intended to serve their patient communities.

Melmeyer also spoke about the growing role of gene therapy in the field of neuromuscular disease, noting that investigational gene therapy candidates, Sarepta Therapeutics’ FDA approved gene therapydelandistrogene moxeparvovec-rokl (marketed as Elevidys) for Duchenne muscular dystrophy, and Novartis’ FDA approved gene therapy onasemnogene abeparvovec-xioi (marketed as Zolgensma) for spinal muscular atrophy will be major focuses at the 2025 MDA conference. He concluded by discussing what he personally is looking forward to at the upcoming conference.

The pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia discussed several still-investigational drugs and therapies for DMD.

John Brandsema, MD, on Potential Upcoming Treatments for Duchenne Muscular Dystrophy

“The bottom line is that we don't think that we are done at all in terms of the approach to this disease. There's much work still to be done in optimizing care and many research trials ongoing because we want to do the best we can for impacting this disease.”

A seminal moment for the treatment of Duchenne muscular dystrophy (DMD) occurred in June 2023 when the FDA approved Sarepta Therapeutics’ delandistrogene moxeparvovec-rokl (marketed as Elevidys), an adeno-associated virus (AAV) vector-based gene therapy, for use in the treatment of the disorder. Although an important step forward that gets at the root cause of the disease, it is not a perfect treatment nor is it curative. As such, many companies and academic institutions are continuing to develop and evaluate new investigational products for DMD that may help to provide better efficacy and safety for some patients, or otherwise address remaining needs that are unmet by Elevidys.

 recently asked John Brandsema, MD, a pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia, whether there are any noteworthy therapeutic candidates for DMD still in development now that may be promising for the future. Brandsema discussed the potential of several new exon-skipping therapies, small molecule drugs like sevasemten, mesenchymal stem cell therapies, and new gene transfer approaches that encode different versions of microdystrophin and/or different AAV capsids. In particular, he noted that these alternative gene transfer therapies may allow for the treatment of patients who would not be eligible to receive Elevidys.

In addition, Brandsema spoke about the importance of establishing standardized newborn screening practices for DMD. He stressed that such practices are useful because earlier treatment, before the disease has caused much deterioration of muscle, is more likely to provide better outcomes. Although, he also pointed out that the optimal timing for different treatments and/or combination therapies is not yet known and more observation is needed.

The pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia discussed the complicated choice doctors, patients, and families now face with a wide range of treatment options available.

John Brandsema, MD, on Navigating the New Landscape of Care for DMD

“If you receive gene transfer with Elevidys, for example, would we continue exon skipping for those who are eligible for it? There's a scientific argument for me why that might be valid, but that may not be approved by the third-party payer of that patient.”

On June 20, 2024, the FDA approved Sarepta Therapeutics’ delandistrogene moxeparvovec-rokl (marketed as Elevidys), an adeno-associated virus (AAV) vector-based gene therapy for patients with Duchenne muscular dystrophy (DMD), for an expanded indication, making it an option for ambulatory patients (via traditional approval) and nonambulatory patients (via accelerated approval) with a confirmed mutation in the DMD gene who are 4 years of age or older and who do not have any deletion in exon 8 or exon 9 in the gene. As a result of this decision, many more patients became eligible for the gene therapy than were previously, thus adding to the number of FDA-approved treatment options many individual patients can choose between.

 recently interviewed John Brandsema, MD, a pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia, to learn more about how doctors, patients, and their families are now navigating the treatment landscape for DMD in the real world setting. Brandsema discussed several aspects of the treatment landscape that continue to make the decision-making process challenging, such as the need to balance the benefits and risks of a diverse array of approaches to treatment; the lack of data on gene therapy in older patients; and the difficulties of implementing combination treatments, both from the perspective of insurance coverage and from the scientific perspective of monitoring for potential adverse outcomes. With regard to the latter, Brandsema emphasized the friction between a staggered approach to combination treatments, for the sake of scientific rigor, and the desire to give patients everything that might help them as soon as possible in the face of a disease that causes degeneration in muscles over time.

Byrne discussed the gene therapy for DMD.

Making Decisions for DMD Treatment

“The decision process for families is actually quite challenging now because while there are various studies that children can enter into for new therapeutic modalities, there are also a host of approved therapies now that are available and the treatment landscape continues to broaden. We'll see new approaches coming frequently and it's really incumbent upon every provider to remain familiar with all the options that are available to patients and help guide them as to what's best for their child and their family."

Patients with Duchenne muscular dystrophy (DMD) today have the choice between a number of disease-modifying treatment options, such as the several FDA-approved exon-skipping therapies and adeno-associated virus (AAV) vector-based gene therapy in the form of Sarepta Therapeutics’ delandistrogene moxeparvovec-rokl (marketed as Elevidys). Beyond FDA-approved options, patients also have the choice to enroll in one of the many currently ongoing trials testing new investigational drugs, gene-editing approaches, and other experimental therapies. As such, the choice facing patients, families, and their doctors is more complicated than ever for DMD.

 recently interviewed Barry J Byrne, MD, PhD, the chief medical advisor of Muscular Dystrophy Association (MDA) and a physician-scientist at the University of Florida, to get his insight on the navigation of this process for the aforementioned groups. Byrne discussed the current landscape of care and how Elevidys has altered that landscape. He also spoke about the work of DMD advocacy groups like MDA and 

 in distributing important information to patients and families for educational purposes. Byrne additionally discussed several promising investigational treatments that are being evaluated by various companies and institutions right now and pointed out that the potential for combination treatments may expand the breadth of decision-making even further.

The chief medical advisor of Muscular Dystrophy Association (MDA) gave his view on treatment decision-making in the world of new options for DMD.

Barry J Byrne, MD, PhD, on Making Decisions in the Face of Rapidly Expanding Treatment Options

The pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia discussed how Sarepta’s Elevidys has affected the landscape of care for DMD.

John Brandsema, MD, on Balancing Risks and Rewards With Muscular Dystrophy Gene Therapy

“While the label is broad and is for everyone we don't necessarily have the data to back that up yet and that makes the conversation more nuanced. We also aren't sure about the durability of transgene expression. Muscle is a high turnover tissue, and therefore whether this is going to be a lifelong effect is still up in the air; although it does seem, from the early boys treated that there is a measurable difference in their trajectory years after the dose, up to 5 or 6 years at this point now.”

Over the past 5 years or so, the treatment landscape for Duchenne muscular dystrophy (DMD) has rapidly evolved with the arrival of a number of new disease-modifying therapies that have been approved by the FDA. Notably, just last year, Sarepta Therapeutics’ delandistrogene moxeparvovec-rokl (marketed as Elevidys), an adeno-associated virus (AAV) vector-based gene therapy, was approved by the FDA, adding to other options available to patients such as exon-skipping therapies. As such, the decision-making process for treatment for DMD for patients, families, and doctors is now more complex than ever.

In the lead up to World Duchenne Awareness Day, which was held on September 7, 

 reached out to John Brandsema, MD, a pediatric neurologist in the Division of Neurology at Children’s Hospital of Philadelphia, to get his view on the newly emerging landscape of care for DMD and the real-world experience gained with Elevidys in the time since it’s approval a bit more than a year ago. Brandsema briefly discussed the other treatment options for DMD that have come onto the scene in the past 5 years, and then brought the focus to Elevidys, and spoke about some of the distinct advantages and unique risks that it carries as the only AAV vector-based gene therapy currently approved for DMD. He emphasized the need for more long-term data, especially for older patients, as many patients treated thus far have been on the younger end of the spectrum.

Neurology

Latest News