Addressing Unmet Needs in Autoimmune Disease With Cell Therapy

Daniela van Eickels, MD, PhD, MPH

With interest growing in the application of chimeric antigen receptor T-cell (CAR-T) therapy and several other advanced cell therapy modalities to the treatment of autoimmune disease, Bristol Myers Squibb (BMS) has formed the Autoimmunity Cell Therapy Network (ACTioN) Steering Committee in order to foster collaboration and facilitate the advancement of investigational candidates. Following the company's announcement of ACTioN, CGTLive® interviewed Daniela van Eickels, MD, PhD, MPH, the vice president and head of medical affairs for BMS’s Cell Therapy Organization, to learn more.

Van Eickels spoke about the unmet needs in autoimmune disease and how CAR-T may help to address these unmet needs. She also discussed how ACTioN aims to facilitate development of CAR-T therapies in the autoimmune disease field.

CGTLive: Can you give some background information about the current landscape of care for autoimmune diseases and the unmet needs that remain?

Daniela van Eickels, MD, PhD, MPH: People living with severe autoimmune disease like severe lupus, refractory lupus, systemic sclerosis, or inflammatory myopathies, have a high burden of disease—and this is twofold. On the one hand side, it's the disease itself, with recurrent flare ups—and the longer they are or the less controlled they are, they can ultimately lead to end organ damage; for instance, cardiomyopathies or renal insufficiencies, just to mention some of the most important. The disease and the flares do greatly reduce the quality of life of these patients and then put them at the ultimate threat of very severe outcomes for people are having cardiac problems or renal insufficiencies.

But this is not all. There's also the treatments that actually contribute to the burden of the disease. So it's a little bit of a yin and yang trying to help those patients without causing other problems that are more treatment related. So if you think of immunosuppressants or chronic glucocorticoid steroid applications, they also have a certain burden for patients. And so in an optimal case, if we describe that unmet medical need, we would really like to control the disease in a way that the patient has long-term remissions and is off-treatment.

Can you discuss the potential of cell therapy/CAR-T to address these unmet needs?

In the last couple of years, we have shown that we can use the selective approach of CAR T-cell therapies to target certain cell types—in this case, for instance, B-cells. So far, we have focused on B-cells that are malignant, so they have lost the ability to control proliferation. We are now investigating if we can transfer this concept to other B-cells—in this case, B-cells that are dysfunctional and in their dysfunctionality are causing autoimmune diseases.

What is ACTioN and what role do you expect it to play in bringing cell therapy products to autoimmune disease?

ACTioN is a BMS initiative where we are providing a platform that should enable deep connectivity and the building of a network between the different stakeholders that are involved in cellular therapies and how to bring them into the field of autoimmunity. We understand from our past that the patient journey will touch on different disciplines, and it is very important that this is a seamless connectivity along the patient journey.

With this in mind, we have currently focused on 3 pillars for action. Pillar number 1 is the scientific pillar, where we are bringing together leading researchers in the field of immunology, but also cell therapy, and we are identifying together with them key open research questions, and are providing the ability to explore those.

The second pillar is a lot about building knowledge. Everybody has a little token of information—their view on things—and it's only if it comes together that it will become a comprehensive knowledge base. We are focusing on this exchange and education. At the very end, it will be not only a therapy that is provided by the experts that are actually having access to it—but the community field will play an important role in that because they need to identify certain patients that might benefit from those therapies and refer them to where they can get them.

This also speaks to the third pillar. We call it the ecosystem pillar. We have the deep belief that this is a true innovation so it will require some adaptations in the healthcare environment. We are trying to enable early conversations on what needs to change and what needs to happen, so that the these new therapies can actually really benefit a wide array of patients if the data prove that to be beneficial.

This transcript has been edited for clarity.

REFERENCE
1. Taking ACTioN. Bristol Myers Squibb. Website. Accessed October 6, 2024. https://www.bms.com/researchers-and-partners/areas-of-focus/our-research-in-immunology/taking-action.html