Commentary

Video

Overcoming Delays in CAR T for Large B-Cell Lymphoma

Fred Locke, MD, Moffitt Cancer Center, explains why this hematologic cancer is such an attractive target for chimeric antigen receptor (CAR) T-cell therapy, specifically allogeneic, which uses healthy donor cells.

In part 2 of this interview with Frederick L. Locke, MD, lead investigator on the phase 1 ALPHA (NCT03939026) and ALPHA2 (NCT04416984) trials of allogeneic chimeric antigen receptor T-cell therapy (CAR T) in relapsed/refractory large B-cell lymphoma (LBCL), explains why this hematologic cancer is such an attractive target for CAR T, specifically allogeneic, which uses healthy donor cells.

In part 1, Locke explained how CAR T-cell therapy works and the differences between autologous and allogeneic CAR T-cell therapy.

Locke is chair of the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center and Research Institute, in Tampa, Florida.

This transcript was lightly edited for clarity; captions were auto-generated.

Transcript

What specific characteristics of relapsed/refractory LBCL make the blood cancer a promising target for allogeneic CAR T?

We have 3 FDA-approved autologous CAR T-cell therapies for relapsed and refractory large B-cell lymphoma that can be treated. Patients can get those treatments as a third or later line with 3 different FDA-approved treatments, and 2 of those are approved to be given in the second-line setting. They work remarkably well for large B-cell lymphoma.

Large B-cell lymphoma is a cancer of the B cells, the B cells in the body, and it generally grows pretty quickly, and we can actually cure some patients with frontline chemotherapy. That's great, but we're only curing 60% to 70% of patients, and that means many are going to progress and need additional therapy, and oftentimes that's CAR T-cell therapy.

When we use autologous CAR T cells, we have to collect the cells from the patient's blood and turn them into CAR T cells, and that's a process that takes time. It could take 4 weeks or longer to wait for those cells to be manufactured. When we use healthy donor cells, we can give them almost right away because we've already have them premade. There's a huge advantage to using allogeneic CAR T cells vs autologous CAR T cells. And large B-cell lymphoma has proven to be sensitive to autologous CAR T cells, so we want to extend that into the allogeneic space.

Related Videos
AJMC Q&A with Jason Bellet, Dr Geoffrey Rutledge, and Dan Nardi
Kimberly Westrich, MA, chief strategy officer at the National Pharmaceutical Council
Sam Peasah, PhD, MBA, RPh, director for the Center of High-Value Health Care at the University of Pittsburgh Medical Center
Jawad Haider Butt, MD, PhD
Laura Bobolts, PharmD, BCOP, senior vice president of clinical strategy and growth at OncoHealth
Barry Byrne, MD, PhD, Powell Gene Therapy Center at the University of Florida
JC Scott, CEO and president, PCMA
Caspian Oliai, MD, MS, a medical oncologist and hematologist and medical director of the UCLA Bone Marrow Transplantation Stem Cell Processing Center
Neha Kashalikar, PharmD, director of strategic pharmacy consulting, MassHealth
Adam Colburn, JD, vice president for congressional affairs, AMCP
Related Content
AJMC Managed Markets Network Logo
CH LogoCenter for Biosimilars Logo