Dr. Sasine on New Developments With CAR T-Cell Therapy

Joshua P. Sasine, MD, PhD, clinical instructor of medicine, hematologist, and oncologist, University of California, Los Angeles, discusses new developments with CAR T-cell therapy.

Follow-up data from the initial trials of CAR T-cell therapy continue to show benefit with this approach. Moreover, providers have become more accustomed to how to use these therapies. In doing so, they have learned how to make these products safer and predict which patients are most likely to benefit from them. Such strategies include inhibiting cytokines that have a direct implication on the neurotoxicity of the CAR T cells, says Sasine. Another approach is bispecific CAR T cells, which are designed to eradicate one of the escape mechanisms that cancer cells have to avoid CAR T cell recognition.

It’s difficult to predict the likelihood of response to CAR T-cell therapy on an individualized level. However, the field is beginning to understand that there are certain cytokine profiles both before and after CAR T cells are administered that are associated with durable remissions. Moreover, there are certain pre-therapeutic indicators of response, including the depth of conditioning for CAR T cells. Notably, the depth of lymphodepletion can be modified, whereas other factors are merely predictive, concludes Sasine.