Adrian Kilcoyne, MD, MPH, MBA, on Adjusting Expectations for Remission Rates in Non–CAR-T Cell Therapy Trials

This is the second part of an interview with Adrian Kilcoyne, MD, MPH, MBA. For the first part, click here.

“We were spoiled a little in the T-cell therapy space. We came out with CAR-Ts, we've seen exceptional results. We've seen exceptional results in acute lymphocytic leukemia, in diffuse large B-cell lymphoma, we've seen complete remission rates in reach of 60%—and even those data seem to hold true in the real world—so we've seen exceptional results. Following that, cell therapy gets a little bit more difficult. We've seen that in the solid tumor space, we've seen it with natural killer cells—that everyone expects a 60% remission rate. The low hanging fruit may well have been picked now. We know that in order to get optimal impact—and we know it from the studies we've done—that we may have to do more.”

At the American Society of Gene and Cell Therapy (ASGCT) 2023 Annual Meeting, held May 16 to 20, in Los Angeles, California, Adrian Kilcoyne, MD, MPH, MBA, the chief medical officer of Cellularity, gave a presentation entitled “Placental-derived mesenchymal-like adherent stromal cell (MLASC) therapy results in alterations in gene and protein signatures associated with inflammation and fistula formation in patients with Crohn’s disease.” The presentation covered results from a new analysis of gene and protein signatures in blood samples from patients who had participated in several of the company’s legacy clinical trials that evaluated an MLASC therapy approach to treating Crohn disease (CD). The new analysis allowed for evaluations of efficacy at later time points than those originally used as primary outcome measures in the original studies.

In an interview with CGTLive™, Kilcoyne discussed the big-picture implications of the new analysis for the healthcare community. He emphasized that the short-term time points used in the original legacy trials likely did not give an optimal picture of the treatments’ long-term efficacy and spoke about the importance of investing in longer-term studies for this type of therapy. Kilcoyne also noted that the precedents for remission rates with chimeric antigen receptor T-cell (CAR-T) therapies in hematological malignancies may have set unreasonable expectations for other types of cell therapies directed at other indications. In light of this, he highlighted the need for greater investment in next generation constructs for non–CAR-T cell therapies such as the MLASC therapy in question before they become viable commercial candidates.

Click here for more coverage of ASGCT 2023.

REFERENCES
1. Kilcoyne A, Koppisetti S, GloverB, et al. Placental-derived mesenchymal-like adherent stromal cell (MLASC) therapy results in alterations in gene and protein signatures associated with inflammation and fistula formation in patients with Crohn’s disease. Presented at: American Society of Gene and Cell Therapy (ASGCT) 2023 Annual Meeting. May 16-20, 2023; Los Angeles, CA. Abstract #1111