CAR-T Meeting 2026 | The current status of CAR T-cell therapy in adult B-ALL: comparing approved constructs
Valentín Ortiz-Maldonado, MD, Hospital Clinic Barcelona, Barcelona, Spain, provides insight into the current landscape of CAR T-cell therapy for adult B-cell acute lymphoblastic leukemia (B-ALL), highlighting that comparable outcomes have been observed across available CAR T-cell products. Dr Ortiz-Maldonado notes that despite high response rates, patients with high tumor burden will often relapse, suggesting the need for improved patient selection and lymphodepletion regimens to enhance outcomes in this subgroup of patients. 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
I had the possibility of giving this talk about, you know, which is the current status of adult patients with B-ALL receiving CAR T-cell therapy. So one of the key aspects that were discussed in the talk is that today we have several CAR T-cell products which are approved for adult B-ALL. And despite some differences in the baseline characteristics, I would say that they are broadly comparable among trials regarding the median age, number of prior treatment lines, and proportion of prior exposure to allogeneic stem cell transplant, and other targeted therapies...
I had the possibility of giving this talk about, you know, which is the current status of adult patients with B-ALL receiving CAR T-cell therapy. So one of the key aspects that were discussed in the talk is that today we have several CAR T-cell products which are approved for adult B-ALL. And despite some differences in the baseline characteristics, I would say that they are broadly comparable among trials regarding the median age, number of prior treatment lines, and proportion of prior exposure to allogeneic stem cell transplant, and other targeted therapies. And these different drugs, you know, brexucabtagene autoleucel, obecabtagene autoleucel, or also the point-of-care Varnimcabtagene autoleucel, do have some differences also in the incidence and severity of CRS and ICANS, but in the end, we would say that the complete response rate is fairly comparable. It’s around 70% plus. And also the median PFS, the median duration of response is also around a year. So this might reflect that we might be reaching like a ceiling of the duration of the efficacy that might reflect the way that we are giving CAR T-cells right now, which is basically patients receiving therapy with overt hematological situations. So as you can, as you know, disease burden is one of the key drivers of efficacy, of durability of response. Across products, almost all patients’ responses is a very high response rate of 70%, but patients will end up relapsing if they receive CAR T-cells with very high tumor loads. So this might reflect that we might need to do something different. We might improve the way we select patients, especially patients with lower disease burdens. And also, it might also push us to do some things to improve outcomes with the drugs that we already have, not only treating patients with lower disease burden, but also improving lymphodepletion regimens, which is also something, a key driver in early expansion of CAR T-cells.
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Disclosures
Travel grants or honoraria: BMS and Pfizer.
