CAR-T Meeting 2026 | The future of CAR T-cell therapy for B-ALL: multi-infusion strategies, MRD-guided approaches & more
Valentín Ortiz-Maldonado, MD, Hospital Clinic Barcelona, Barcelona, Spain, discusses the future of CAR T-cell therapy for B-cell acute lymphoblastic leukemia (B-ALL), emphasizing the importance of administering CAR T-cells earlier in the disease course when disease burden is lower, and exploring strategies such as intensified lymphodepletion, multi-infusion approaches, and measurable residual disease (MRD)-guided therapy to improve outcomes and reduce the risk of post-CAR-T relapse. This interview took place at the EBMT-EHA 8th European CAR T-cell Meeting, held in Palma de Mallorca, Spain.
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Transcript
So I truly believe that the future in B-ALL, if we want to obtain the best outcomes with current constructs, is basically taking patients to CAR T-cell earlier with lower disease burden. So we need to apply in a more clever way the targeted therapies that we already have, inotuzumab, blinatumomab, and also try to improve lymphodepletion, the intensity of lymphodepletion...
So I truly believe that the future in B-ALL, if we want to obtain the best outcomes with current constructs, is basically taking patients to CAR T-cell earlier with lower disease burden. So we need to apply in a more clever way the targeted therapies that we already have, inotuzumab, blinatumomab, and also try to improve lymphodepletion, the intensity of lymphodepletion. The other thing is we might need to move from single infusion strategies to multi-infusion strategies. Because probably by trying to give therapy with a single infusion, we need to reduce the dose to one that is safe for most of patients. And by doing this, it’s safe but you also compromise efficacy in the long run. And also for post-transplant interventions, this has to be guided through deep MRD tests, for instance, NGS-guided tests that have proven in some trials to be very good tools to better improve the guidance of both CAR-T and other interventions, such as allogeneic stem cell transplant and also other targeted therapies like TKIs, or other studies that could be basically reinfusions or another CAR T-cell for another target.
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Disclosures
Travel grants or honoraria: BMS and Pfizer.
