Dr Andre Goy Discusses Potential Benefits of Earlier Use of CAR T Therapies

Andre Goy, MD, chairman, director, and chief of the Division of Lymphoma at John Theurer Cancer Center in Hackensack, NJ, discussed the potential benefits of using CAR T-cell therapies as a second-line treatment.

Transcript

After the approval of the first CAR T-cell therapies there was a discussion at ASCO about whether these therapies should be used earlier, when they might be more effective. What is the current thinking on this issue?

It is a very important aspect of CAR T-cell therapy because it is a game changer. And roughly 30-40% of patients have long-term benefits, particularly in aggressive lymphoma. That's sort of a main focus today. And what that means is that they're still 2 thirds of the patients who don't necessarily benefit or relapse after CAR T.

So, the question is how we can improve the concept of T-cell fitness and lessen the exposure to biochemotherapy for T-cells and the immune system. That seems to be very important. There're additional biomarkers, the inflammatory [garbled] prior to CAR T-cells that affects the response as well.

The next step is, because we've seen some activity in patients who have failed multiple lung therapy, can we actually take advantage of the CAR T-cell therapy earlier. To answer your question, there are ongoing trials that are looking at using CAR T, instead as a third line, like it is approved now, as a second line randomization versus an autologous stem cell transplant. All of these trials are being completed, like ZUMA-7. But there's also ongoing trials, that are looking at exactly the same question, to see if we can we actually improve the outcome of patients with larger lymphoma relapse, where we know with autologous stem cell transplantation, particularly in the early failure primary factory, has a very small percentage of long-term good outcome, using CAR T-cell therapy? So, there will be data at ASH's [American Society of Hematology] Annual Meeting. And some of these clinical trials are still ongoing, but it is very promising to try to bring a CAR T-cell earlier and improve the outcome in these patients.