Medical Research: What is the background for this study? What are the main findings?
Dr. Loskog: CAR T cells have shown remarkable effect in patients with B cell malignancy in the US using 2nd generation CAR T cells. Acute leukemia (ALL) seems easier to treat than lymphomas and one of the reasons may be difficulties for CAR T cells to penetrate a solid lesion or due to a higher local presence of immunosuppressive cells within a lesion. As one of the first centers outside US we are evaluating 3rd generation CAR T cells in both lymphoma and ALL aiming to compare the responses and investigating biological reasons for the different responses. So far we have treated 11 patients and 6 of them had initial complete responses. Unfortunately, some progressed later.
Medical Research: What should clinicians and patients take away from your report?
Dr. Loskog: It is possible to achieve complete responses also in lymphoma with low doses of preconditioning only. However, for sustained effect it may be necessary to give the patients supportive treatment also after T cell infusion that keep the level of suppressive immune cells low. There is great promise in CAR T cell therapy but we are yet to define the best protocol to achieve longterm complete responses in lymphoma patients.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Loskog: We are currently investigating the immunosuppressive environment in the patients before and after CAR T cell therapy and initial data support increasing immunosuppression with time. A supportive treatment given after CAR T cell infusion needs to reduce suppressive immune cells at the same time leaving CAR T cells active. Finding and testing such drugs to be used together with CAR T cell therapy, or immunotherapy in general, is a crucial task for the future.
Abstract 041 CD19-targeting third generation CAR T cells for relapsed and refractory lymphoma and leukemia report from the Swedish phase I/IIa trial. Gunilla Enblad, Hannah Karlsson, Kristina I Wikstrom,
Magnus Essand, Barbara Savoldo, Malcolm K Brenner, Gianpietro Dotti, Martin Hoglund, Hans Hagberg, Angelica Loskog.
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Angelica Loskog, PhD (2015). CAR T cells For Relapsed Lymphoma and Leukemia MedicalResearch.com
Angelica Loskog, PhD (2015). Third Generation CAR T cells For Relapsed Lymphoma and Leukemia