CAR T-Cell Therapy in Acute Lymphoblastic Leukemia May Achieve ‘Deep Remission’

Putting patients into remission

• The CAR T-cell therapy tisagenlecleucel (brand name: Kymriah) is FDA-approved for patients 25 and under with relapsed/refractory ALL
• This therapy doesn’t cure all patients, but it can produce remission
• Putting patients into remission could enable them to have a stem cell transplant

The chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (brand name: Kymriah) is an FDA-approved treatment for children and young adults with relapsed or refractory acute lymphoblastic leukemia.

“The T cells are harvested from the patient. They are engineered in the lab to express a receptor that allows that T cell to target CD19,” Dr. Olalekan Oluwole, assistant professor of medicine in Hematology/Oncology at Vanderbilt University Medical Center, tells SurvivorNet Connect. “In the future, maybe we will have an off-the-shelf product. In other words, we may not need the patient’s T cells. We may actually use an allogenic T cell to do the same job.”

Although CAR T-cell therapy doesn’t cure everyone, it does clear out cancer cells in the bone marrow of patients with relapsed ALL and lead to remission. This could enable patients to undergo a stem cell transplant that will produce a durable remission. “Being able to get into that deep remission is what this CAR T can achieve,” Dr. Oluwole says. “We also believe that a fraction of patients may be able to be cured by the CAR T, although that data is not yet available.”