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ISAL 2025 | CAR T-cells in AML: challenges and the role of the microbiome
Hendrik Poeck, MD, University Hospital Regensburg, Regensburg, Germany, comments on the challenges of using CAR T-cells for the treatment of acute myeloid leukemia (AML), highlighting the need for further research to identify an optimal target. Prof. Poeck notes that the microbiome plays a crucial role, and explains how the microbiome could be manipulated to improve treatment responses. This interview took place at the 19th International Symposium on Acute Leukemias (ISAL XIX) in Munich, Germany.
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Transcript
So, yes, this is a difficult question. We do have great success in myeloma and lymphoma, of course, but still we don’t have the optimal target in AML and we still need to do a lot of research in AML also to minimize toxicities in patients with AML that are supposed to get CAR T-cells, so I think a lot of research is still required to really use CAR T-cells in AML...
So, yes, this is a difficult question. We do have great success in myeloma and lymphoma, of course, but still we don’t have the optimal target in AML and we still need to do a lot of research in AML also to minimize toxicities in patients with AML that are supposed to get CAR T-cells, so I think a lot of research is still required to really use CAR T-cells in AML. I think the microbiome will play a really important role in that. So we know that broad-spectrum antibiotics really impair the effect of CAR T-cell efficacy and perhaps also influence toxicities mediated by CAR T-cells. We can probably also use microbiome components to drive efficacy and also to correct the disturbed microbiome that broad-spectrum antibiotics induce. And this is also one of the strategies that we are trying to do, trying to define the components of the microbiome that drive these responses and then also use microbiota transfer to correct this disturbed microbiome profile in a patient. And currently we are preparing a clinical study within the NCT network in patients with multiple myeloma, which have been exposed to broad-spectrum antibiotics, where we want to apply microbiota transplantation to correct this disturbance and then perhaps also improve treatment responses and maybe also minimize toxicities.
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